Resistant Hypertension: Diagnosis and Management

Nagalakshmi Nagarajan; Diana Jalal

doi:10.1053/j.ackd.2019.03.002

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Resistant Hypertension: Diagnosis and Management

Journal article

Peer reviewed

Resistant Hypertension: Diagnosis and Management

Nagalakshmi Nagarajan and Diana Jalal

Advances in chronic kidney disease, Vol.26(2), pp.99-109

03/2019

DOI: 10.1053/j.ackd.2019.03.002

PMID: 31023454

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Abstract

Resistant hypertension is defined as high blood pressure requiring 3 or more medications for adequate control or controlled blood pressure requiring 4 or more medications. Considering the growing prevalence of hypertension and the strong link with cardiovascular disease, it is vital to understand the causes and treatment of resistant hypertension. This review article starts with an overview of the prevalence and little-known pathophysiology of resistant hypertension. Afterward, we discuss the evaluation and management of suspected secondary resistant hypertension in 2 broad categories: pseudoresistant hypertension and true resistant hypertension. Strategies for the identification and management of pseudoresistant hypertension are addressed. In addition, causes of true resistant hypertension, such as obstructive sleep apnea, primary aldosteronism, and renal artery stenosis, are examined along with their respective treatments. Finally, treatment of resistant hypertension is reviewed including pharmacologic treatments and novel procedural interventions for resistant hypertension. Overall, the review hopes to provide practitioners with a cohesive approach for the diagnosis and treatment of resistant hypertension.

Adrenal Cortex Neoplasms - complications

Adrenal Cortex Neoplasms - diagnosis

Adrenal Cortex Neoplasms - therapy

Adrenal Gland Neoplasms - complications

Adrenal Gland Neoplasms - diagnosis

Adrenal Gland Neoplasms - therapy

Adrenocortical Adenoma - complications

Adrenocortical Adenoma - diagnosis

Adrenocortical Adenoma - therapy

Alcohol Drinking - adverse effects

Anti-Inflammatory Agents, Non-Steroidal - adverse effects

Antihypertensive Agents - therapeutic use

Cushing Syndrome - complications

Cushing Syndrome - diagnosis

Cushing Syndrome - therapy

Diet, Sodium-Restricted

Drug Resistance

Humans

Hyperaldosteronism - complications

Hyperaldosteronism - diagnosis

Hyperaldosteronism - therapy

Hypertension - drug therapy

Hypertension - etiology

Hypertension - physiopathology

Medication Adherence

Obesity - complications

Pheochromocytoma - complications

Pheochromocytoma - diagnosis

Pheochromocytoma - therapy

Pituitary ACTH Hypersecretion - complications

Pituitary ACTH Hypersecretion - diagnosis

Pituitary ACTH Hypersecretion - therapy

Renal Artery Obstruction - complications

Renal Artery Obstruction - diagnosis

Renal Artery Obstruction - therapy

Renal Insufficiency, Chronic - complications

Renal Insufficiency, Chronic - diagnosis

Renal Insufficiency, Chronic - therapy

Sleep Apnea, Obstructive - complications

Sleep Apnea, Obstructive - diagnosis

Sleep Apnea, Obstructive - therapy

Sodium Chloride, Dietary

White Coat Hypertension

Details

Title: Subtitle: Resistant Hypertension: Diagnosis and Management
Creators: Nagalakshmi Nagarajan - University of Iowa Hospitals and Clinics
Diana Jalal - Division of Renal Diseases and Hypertension, Department of Medicine, University of Iowa Hospital and Clinics, Iowa City, IA
Resource Type: Journal article
Publication Details: Advances in chronic kidney disease, Vol.26(2), pp.99-109
DOI: 10.1053/j.ackd.2019.03.002
PMID: 31023454
ISSN: 1548-5595
eISSN: 1548-5609
Language: English
Date published: 03/2019
Academic Unit: Nephrology; Internal Medicine
Record Identifier: 9984359696702771

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