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Resistant Hypertension Strategies Reviewed

Patient education, use of antihypertensive drugs important in management of condition

FRIDAY, Nov. 21 (HealthDay News) -- Resistant hypertension is a relatively common medical problem requiring careful diagnostic evaluation and optimized treatment strategies, according to an overview of the topic published in the Nov. 25 issue of the Journal of the American College of Cardiology.

Pantelis A. Sarafidis, M.D., Ph.D., of the Aristotle University of Thessaloniki, Greece, and a colleague defined resistant hypertension as the failure to achieve a blood pressure goal in spite of patient adherence to the maximum tolerated doses of three antihypertensive drugs. The authors note that it is important to distinguish resistant hypertension from pseudo-resistant hypertension, which may be due to improper blood pressure measurement, poor adherence to lifestyle modification or medication by patients, or the white-coat effect.

Following confirmation of diagnosis, treatment of resistant hypertension requires identification and modification of factors contributing to the blood pressure increase, the authors write. Several treatment strategies are used to manage resistant hypertension. These strategies include patient education and reinforcement of lifestyle issues affecting blood pressure, exclusion of agents that may contribute to the resistance, and the use of antihypertensive agents focused on treating the cause of the hypertension.

"Although the number of patients who cannot achieve blood pressure goals on a regimen of multiple medications is growing, the phenomenon of resistant hypertension is widely understudied," the authors write, adding that this "requires treatment recommendations be based on pathophysiological principles and clinical experience."

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