Jove
Visualize
Contact Us
JoVE
x logofacebook logolinkedin logoyoutube logo
ABOUT JoVE
OverviewLeadershipBlogJoVE Help Center
AUTHORS
Publishing ProcessEditorial BoardScope & PoliciesPeer ReviewFAQSubmit
LIBRARIANS
TestimonialsSubscriptionsAccessResourcesLibrary Advisory BoardFAQ
RESEARCH
JoVE JournalMethods CollectionsJoVE Encyclopedia of ExperimentsArchive
EDUCATION
JoVE CoreJoVE BusinessJoVE Science EducationJoVE Lab ManualFaculty Resource CenterFaculty Site
Terms & Conditions of Use
Privacy Policy
Policies

Related Experiment Videos

An algorithm for the management of resistant hypertension.

R W Gifford1

  • 1Department of Hypertension and Nephrology, Cleveland Clinic Foundation, OH 44106.

Hypertension (Dallas, Tex. : 1979)
|March 1, 1988
PubMed
Summary

Resistant hypertension requires ruling out adherence issues, drug interactions, and secondary causes before considering hemodynamic assessment. Further investigation guides tailored treatment for difficult-to-manage high blood pressure.

Related Concept Videos

You might also read

Related Articles

Articles linked to this work by shared authors, journal, and citation graph.

Sort by
Same author

General discussion (afternoon session).

Bulletin of the New York Academy of Medicine·2009
Same author

Lessons from recent hypertension trials: how low to lower blood pressure.

Southern medical journal·2000
Same author

Hyperhomocysteinemia and other coronary risk factors in 20-year renal transplant recipients (level 5A) with and without coronary heart disease.

Transplantation proceedings·1999
Same author

The incidence and management of osteoporosis, gout, and avascular necrosis in recipients of renal allografts functioning more than 20 years (level 5A) treated with prednisone and azathioprine.

Transplantation proceedings·1999
Same author

Chronic viral hepatitis in renal transplant recipients with allografts functioning for more than 20 years.

Transplantation·1999
Same author

New hypertension guidelines set aggressive goals based on risk factors. Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure.

Cleveland Clinic journal of medicine·1998

Area of Science:

  • Cardiology
  • Nephrology
  • Pharmacology

Background:

  • Resistant hypertension poses a significant clinical challenge, often requiring complex management strategies.
  • Identifying non-adherence, drug interactions, and secondary causes is crucial before diagnosing true resistant hypertension.

Purpose of the Study:

  • To outline the essential differential diagnoses and investigations for patients with hypertension presumed to be resistant to triple therapy.
  • To emphasize the importance of excluding confounding factors before proceeding to advanced hemodynamic assessment.

Main Methods:

  • Review of clinical guidelines and literature regarding the management of resistant hypertension.
  • Discussion of common causes of pseudotolerance and pseudoresistance.
  • Highlighting the role of secondary hypertension workup (e.g., renovascular disease, primary aldosteronism, pheochromocytoma).

Main Results:

  • Several factors can mimic true resistant hypertension, including poor adherence, drug interactions, and fluid retention.
  • Unrecognized secondary causes of hypertension are frequently encountered.
  • Hemodynamic measurements are valuable after excluding other causes to guide therapy.

Conclusions:

  • Thoroughly exclude adherence issues, drug interactions, pseudotolerance, and secondary causes before diagnosing resistant hypertension.
  • Hemodynamic assessment is indicated in refractory cases to identify specific pathophysiological mechanisms.
  • Personalized therapeutic adjustments based on identified mechanisms can improve blood pressure control.

Related Experiment Videos