Resistant hypertension: patient characteristics, risk factors, co-morbidities and outcomes

摘要: Among the vast population of hypertensive subjects, between 10 and 15% do not achieve an adequate blood pressure (BP) control despite use at least three antihypertensive agents. This group, designated as having resistant hypertension (RH), represents one most important clinical challenges in evaluation management. Resistant hypertensives are characterized by several particularities, such a longer history hypertension, obesity other accompanying factors, diabetes, left ventricular hypertrophy, albuminuria renal dysfunction. In addition to diagnostic therapeutic maneuvers, excluding secondary ensuring treatment adherence optimizing schemes, ambulatory BP monitoring (ABPM) is crucial patients with RH. ABPM distinguish those out-of-office elevation (true hypertensives) white-coat RH (WCRH; normalcy 24-h BPs), prevalence latter estimated about one-third True also exhibit more frequently co-morbidities, severe target organ damage worse cardiovascular prognosis, comparison WCRH. Some device-based therapies have recently been developed for requires better characterization potential candidate population. A knowledge features confirmation elevated values out doctor's office, improvements search causes would help select candidates newer therapies, once pharmacological possibilities exhausted.