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- W2588980211 abstract "### Learning objectivesHigh blood pressure (hypertension) is one of the most important risk factors for cardiovascular disease,1 2 which is a significant cause of morbidity and mortality worldwide.3 Recent surveys from developed countries suggest that the prevalence of hypertension ranges from 20% to 30%, with 51%–80% receiving treatment but only 27%–66% with adequate blood pressure control.4 One subset of uncontrolled hypertensives who do not respond to treatment are known as resistant hypertensives. This article will describe how resistant hypertension is defined, its prevalence and prognosis, methods to diagnose it effectively in routine practice and strategies to effectively manage patients diagnosed with the condition.### Definition of resistant hypertensionResistant hypertension is generally defined as uncontrolled clinic blood pressure (>140/90 mm Hg) after treatment with three or more antihypertensives.5 In the UK, National Institute for Health and Care Excellence (NICE) guidelines specify that these three should include optimal doses of an ACE inhibitor (or an angiotensin receptor blocker), a calcium channel blocker and a diuretic.6 However, there are some circumstances which preclude resistant hypertension, which must be ruled out before a formal diagnosis can be made. The so-called ‘pseudoresistant’ hypertension can be caused by poor clinic blood pressure measurement technique, patient non-adherence to prescribed medication, patient intolerance to certain antihypertensive medications and white coat hypertension (where blood pressure appears high in the clinic but is controlled out-of-the-office on home or ambulatory measurements).5 ### Prevalence and prognosisMost prevalence studies have been conducted in the USA using routine medical records and in that setting resistant hypertension is thought to be relatively common, affecting anywhere between 9% and 18% of patients with diagnosed hypertension (table 1 …" @default.
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- W2588980211 date "2017-06-29" @default.
- W2588980211 modified "2023-09-23" @default.
- W2588980211 title "Diagnosis and management of resistant hypertension" @default.
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- W2588980211 doi "https://doi.org/10.1136/heartjnl-2015-308297" @default.
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