[Refractory hypertension--principles of combination therapy]

"Non response" to treatment of hypertension may have different reasons: it may be "physician-related" ("white coat hypertension"), of "patient related" (poor adherence to prescribed medication, alcohol abuse, obesity) and it may really be a "resistant hypertension". In such cases one should search for a primary disease. If no such disease is found one should--according to the time-factor--wait for several weeks before increasing the dose; later on one should switch to another drug with a different mechanism of action and, if necessary, use a rational combination.