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What Is Resistant Hypertension and Why Should You Care?
Published: Aug 16, 2024
Resistant hypertension is a stubborn form of high blood pressure that doesn't respond to typical treatments. It affects millions and can lead to serious health problems if left unchecked.
Defining the Problem
Resistant hypertension occurs when your blood pressure stays above goal despite taking three different blood pressure medications, including a diuretic. It's like having a car that won't slow down no matter how hard you press the brakes. This condition affects about 10-20% of people with high blood pressure and puts them at higher risk for heart attacks, strokes, and kidney problems.
Causes and Risk Factors
Several factors can contribute to resistant hypertension. These include being older, overweight, or having conditions like diabetes or kidney disease. Certain medications, a high-salt diet, and not taking blood pressure drugs as prescribed can also play a role. It's like trying to sail a boat against strong winds and currents – multiple forces are working against you.
Spotting the Imposters
Sometimes, what looks like resistant hypertension isn't the real deal. This 'pseudoresistance' can be due to inaccurate blood pressure measurements, the 'white coat effect' (higher readings at the doctor's office), or not taking medications properly. It's crucial to rule these out before diagnosing true resistant hypertension.
Uncovering Hidden Causes
In some cases, resistant hypertension may be a sign of an underlying condition. Common culprits include hormonal disorders like primary aldosteronism, narrowed kidney arteries, or sleep apnea. Identifying these root causes is like solving a medical mystery – it requires careful investigation but can lead to more effective treatment.
Frequently Asked Questions
It affects about 10-20% of people with high blood pressure.
Yes, reducing salt intake and losing weight can make a big difference.
Not necessarily, treating underlying causes can sometimes resolve it.
Researchers are exploring options like renal denervation.
If your BP remains high despite multiple medications, consult a hypertension expert.
Taking Control
While resistant hypertension is challenging, understanding it is the first step towards better management and improved health outcomes.
References
- Carey RM, et al. Resistant Hypertension: Detection, Evaluation, and Management: A Scientific Statement From the American Heart Association. Hypertension 2018; 72:e53.
- Whelton PK, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults. Hypertension 2018; 71:e13.
- de la Sierra A, et al. Clinical features of 8295 patients with resistant hypertension classified on the basis of ambulatory blood pressure monitoring. Hypertension 2011; 57:898.
This article has been reviewed for accuracy by one of the licensed medical doctors working for Doctronic. Always discuss health information with your healthcare provider.
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