Key result
Resistant hypertension requires careful exclusion of pseudo-resistance and secondary causes to establish an effective therapeutic strategy and prevent cardiovascular complications.
Why the study?
Resistant hypertension predisposes individuals to a higher risk of cardiovascular diseases, requiring the exclusion of pseudo-resistance and secondary hypertension to ensure proper identification.
This review highlights the critical steps in diagnosing true resistant hypertension, including ruling out pseudo-resistance and secondary causes, to guide appropriate management and prevent cardiovascular complications.
Highlights diagnostic vigilance in resistant hypertension; leaves open optimal management strategies pending higher-level evidence.
High blood pressure is a very important risk factor for the development of Cardiovascular Diseases (CVD), which are among the main causes of death globally. In particular, Resistant Hypertension (RH) predisposes individuals to a higher risk of CVD. RH is defined as the absence of blood pressure control despite the use of at least three classes of antihypertensive agents, one of them being a diuretic, in optimal dosage. To identify true RH, it is essential to exclude specific clinic conditions, such as pseudo-resistance and causes of Secondary Hypertension (SR), since these situations can also be related to poorly controlled hypertension. A large number of factors may be investigated to exclude pseudo-resistance, which includes: non-adherence to the antihypertensive therapy, white coat hypertension, inaccurate blood pressure measurement, non-optimized therapeutic scheme, low acceptance of the need for life-style modifications. In this review we will address the aspects of the pathophysiology, diagnosis and treatment of HR.
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O’Connell et al. (2019) conducted a review in Resistant hypertension. Evaluation and management of resistant hypertension was evaluated. Resistant hypertension requires careful exclusion of pseudo-resistance and secondary causes to establish an effective therapeutic strategy and prevent cardiovascular complications.
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