Journal article
Resistant hypertension: Identifying causes and optimizing treatment regimens
Southern medical journal (Birmingham, Ala.), Vol.101(2), pp.166-173
02/01/2008
DOI: 10.1097/SMJ.0b013e31816171cb
PMID: 18364619
Abstract
Management of resistant hypertension (RH), defined as uncontrolled blood pressure on three or more antihypertensive medications including a diuretic, begins initially with identifying and addressing contributors such as medication adherence, lifestyle factors and the use of interfering substances. Evaluation for the "white-coat" phenomenon, or associated conditions and secondary causes such as sleep apnea, primary aldosteronism, chronic kidney disease or renovascular disease may be indicated. Inadequate dosing, lack of using long-acting diuretics, and suboptimal combinations are observed as causes in nearly half of patients with RH. Appropriate pharmacotherapy of RH begins first with insuring the patient is receiving appropriate therapy for compelling indications, as outlined by the JNC-7 guidelines. Specific regimen enhancements to achieve blood pressure control include the addition of aldosterone antagonists, dual renin-angiotensin system blockade, and dual calcium channel blockade. Addition of centrally acting agents; alpha blockers, or vasodilators may also be necessary.
Details
- Title: Subtitle
- Resistant hypertension: Identifying causes and optimizing treatment regimens
- Creators
- Cora Lynn B. Trewet - University of IowaMichael E. Ernst - Univ Iowa, Coll Pharm, Dept Family Med, Div Clin & Adm Pharm, Iowa City, IA 52242 USA
- Resource Type
- Journal article
- Publication Details
- Southern medical journal (Birmingham, Ala.), Vol.101(2), pp.166-173
- Publisher
- Lippincott Williams & Wilkins
- DOI
- 10.1097/SMJ.0b013e31816171cb
- PMID
- 18364619
- ISSN
- 0038-4348
- eISSN
- 1541-8243
- Number of pages
- 8
- Language
- English
- Date published
- 02/01/2008
- Academic Unit
- Family and Community Medicine; Pharmacy Practice and Science
- Record Identifier
- 9984297450302771
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