Med. praxi. 2013;10(4):139-141

Treatment options of resistant hypertension

doc.MUDr.Věra Čertíková Chábová, Ph.D.

Klinika nefrologie 1. lékařské fakulty a Všeobecné fakultní nemocnice, Praha

Resistant hypertension is defined as hypertension that remains uncontrolled despite treatment with three different optimally dosed

antihypertensive agents, one of which is a diuretic. Prior to making a definitive diagnosis, it is necessary to rule out pseudoresistance

that is often caused by the fact that the patient is not taking medications as prescribed. It is also of importance to eliminate factors that

increase blood pressure, such as excessive salt intake and use of medications and other substances causing hypertension. Not uncommonly,

resistance may occur in secondary hypertension due to obesity, sleep apnoea syndrome, vascular and endocrine diseases, or

intracranial tumours. Medications must always contain an appropriately selected diuretic at a sufficient dose. In clinical trials today, it is

also possible to use nonpharmacological strategies, such as renal denervation or stimulation of the carotid sinus.

carotid sinus stimulation.

Keywords: resistant hypertension, secondary hypertension, hypertension management, diuretics, catheter-based renal denervation,

Published: April 15, 2013  Show citation