Why the study?
Resistant hypertension carries increased cardiovascular risk and affects a growing absolute number of patients, warranting an updated management algorithm incorporating emerging pharmacological and interventional evidence.
This review provides an updated algorithm for the management of resistant hypertension, incorporating lifestyle, pharmacological, and interventional approaches.
Updated resistant hypertension algorithm incorporates latest evidence; leaves open need for prospective validation before changing practice.
Resistant hypertension (RH) is a severe form of hypertension associated with increased cardiovascular risk. Although true RH affects less than 10% of the patients receiving antihypertensive therapy, the absolute number is high and continues to increase. The workup of these patients requires screening for secondary hypertension and pseudoresistance, including poor adherence to prescribed medicines and the white-coat phenomenon. The treatment of RH consists of lifestyle modifications and pharmacological therapies. Lifestyle modifications include dietary adjustments, weight loss, physical activity, and limiting alcohol consumption; pharmacological therapies include diuretics, mineralocorticoid receptor antagonists, beta blockers, angiotensin receptor-neprilysin inhibitors, and others. Over the last 15 years, interventional approaches have emerged as adjunct treatment options; we highlight catheter-based renal denervation. This review summarizes the rationales and latest clinical evidence and, based thereon, proposes an updated algorithm for the management of RH.
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Lauder et al. (2023) studied this question.
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