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Resistant hypertension. Introduction and definitions.

R W Gifford1

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

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

Resistant hypertension is defined as blood pressure not controlled by a three-drug regimen. This definition applies to patients with high initial blood pressure or those not reaching normal levels on treatment.

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Area of Science:

  • Cardiology
  • Nephrology
  • Pharmacology

Background:

  • Resistant hypertension poses a significant challenge in cardiovascular disease management.
  • Accurate definition is crucial for appropriate treatment strategies.

Purpose of the Study:

  • To propose a clear and actionable definition for resistant hypertension.
  • To guide clinicians in identifying and managing this condition.

Main Methods:

  • The study proposes a definition based on treatment response to a triple-drug regimen.
  • Adherence to medication and specific blood pressure thresholds are considered.

Main Results:

  • Resistant hypertension is defined as uncontrolled blood pressure ( 150/100 mm Hg) despite a triple-drug regimen (including a diuretic) at maximal doses, for patients with initial systolic blood pressure >= 180 mm Hg or diastolic blood pressure >= 115 mm Hg.
  • For patients with initial blood pressure < 180/115 mm Hg, resistant hypertension is defined as failure to achieve normotension (< 140/90 mm Hg) on the same regimen.

Conclusions:

  • The proposed definition provides clear criteria for identifying resistant hypertension.
  • This definition aims to standardize diagnosis and facilitate effective management of resistant hypertension.

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