Transdisciplinary approaches to the prevention and treatment of medication-resistant hypertension in young people (literature review)

Background. Medication-resistant arterial hypertension in people aged 10–30 years is clinically important because persistent blood pressure elevation is associated with early target-organ damage and long-term cardiovascular risk. Aim. To examine current approaches to the prevention and treatment of medication-resistant hypertension in people aged 10–30 years, including non-pharmacological and pharmacological strategies and transdisciplinary models of care. Materials and Methods. This article presents a narrative review of the scientific literature of the past 10 years retrieved from the PubMed, Scopus and Web of Science databases. Inclusion criteria were English-language peer-reviewed clinical and cohort studies, randomized controlled trials, clinical guidelines, systematic reviews, and directly relevant narrative reviews addressing people aged 10–30 years; adult-only studies without applicability to this age range, conference abstracts without full text, and non-peer-reviewed material were excluded. The study was conducted as a private initiative of the authors, without grant support or state registration of the research topic. Research Ethics. The review analyzed only published data whose authors declared compliance with ethical standards. Results. Resistant hypertension was treated as an age-specific phenotype: adult criteria require at least three drugs of different classes, including a diuretic, at maximally tolerated doses with confirmation of uncontrolled values outside the clinic, whereas pediatric criteria are percentile-based. Pseudoresistance caused by non-adherence, the white-coat effect, and measurement error has to be excluded first. Obesity, short sleep, high sodium intake, energy-drink consumption, marked prematurity, and very low birth weight are identifiable contributors, while renal, renovascular and endocrine secondary causes require targeted evaluation. Lifestyle modification and age-adapted pharmacotherapy are supported, but evidence or direct intervention in this age range remains limited. Conclusions. The aim was achieved: transdisciplinary approaches to the prevention, diagnosis, and treatment of medication-resistant arterial hypertension among people aged 10–30 years were identified and systematized. Diagnostic verification precedes the diagnosis of true resistance; secondary and pseudoresistant forms require targeted evaluation; transdisciplinary care is justified as an organizational framework, although comparative studies are lacking.