Identification and management of resistant hypertension

Abstract

Resistant hypertension is defined as blood pressure being higher than the patient s target blood pressure despite the use of three or more different types of antihypertensive drugs at the optimal dose, and one of them should be a diuretic. The evaluation of patients with resistant hypertension should first confirm that they have true resistant hypertension. By eliminating or correcting false resistance factors, such as white coat hypertension, poor blood pressure measurement technique, poor drug compliance, improper dosage or combination of antihypertensive drugs, and white coat effects and clinical inertia. Resistant hypertension therapy includes improved compliance with the use of drugs, secondary hypertension detection and treatment, use of lifestyle measures and treatment of obesity, and other comorbidities. switching to a long-acting diuretic type of thiazide like chlorthalidone could improve the BP from the patients taking hydrochlorothiazide. This review paper illustrates briefly the identification of the underlying causes of resistant hypertension and therapeutic strategies, which may contribute to the proper diagnosis and an improvement of the long term management of resistant hypertension.