Current approaches to the diagnosis and treatment of resistant hypertension

Objective & Hypothesis:Resistant hypertension (RHT) is a clinical state in which despiteconcomitant intake of at least three antihypertensive drugs, oneof these preferably being a diuretic at full doses, blood pressurecontrol can not be achieved.

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Key Findings & Data:Priorly, it should be confirmed thatthe patients with resistant hypertension have true RHT which canbe performed by ruling out factors associated with pseudo-resistance which include inaccurate measurement of blood presure(BP), inadequate treatment plan, non-adherence to prescribedtherapy, or the white-coat effect.

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Conclusion & Impact:For this reason;the best choice for treatment of RHT seems to be full adherenceto medication and life style change of patients with RHT

🔬Design:Research Article

📍Scope:Comprehensive Sample

⚙️Variables:Domain Parameters

Abstract

Resistant hypertension (RHT) is a clinical state in which despiteconcomitant intake of at least three antihypertensive drugs, oneof these preferably being a diuretic at full doses, blood pressurecontrol can not be achieved. Priorly, it should be confirmed thatthe patients with resistant hypertension have true RHT which canbe performed by ruling out factors associated with pseudo-resistance which include inaccurate measurement of blood presure(BP), inadequate treatment plan, non-adherence to prescribedtherapy, or the white-coat effect. The complexity of the treatment regimen, socioeconomic status, lifestyle and psychological influences mainly effect compliance to treatment. Treatmentmethods being researched for the management of RHT includeinvasive, irreversible such as renal denervation and proceduresapplied using implantable devices as carotid baroreceptor stimulation. Because of inadequate number of data favouring renaldenervation, it is unclear whether renal denervation may benefita subset of patients with resistant hypertension. For this reason;the best choice for treatment of RHT seems to be full adherenceto medication and life style change of patients with RHT

Özet

Rezistan hipertansiyon (RHT), bir tanesi maksimum dozda diüretik olmak üzere en az üçlü anti-hipertansif tedaviye rağmen kan basıncı kontrolünün sağlanamadığı klinik durum olarak adlandırılır. Öncelikle kan basıncının yanlış ölçümü, yetersiz tedavi planı, tedaviye uymsuzluk veya beyaz önlük etkisi gibi psödo resistan durumların dışlanması, gerçek resistan hipertansiyon tanısı koyabilmek için önemlidir. Tedavi rejiminin karmaşıklığı,sosyoekonomik statü, yaşam şekli psikolojik etkiler tedavi ye uyumu etkileyen temel etmenlerdir. RHT için araştırılmakta olan tedaviler arasında renal denervayson gibi invazif geri dönüşümsüz prosedürler ve karotis baroreseptör stimulasyonu gibi implante edilebilir aletler ile yapılan tedaviler RHT için araştırılmakta olan tedaviler arasında yer almaktadır. Renal denarvasyonun RHT tedavisindeki yeri ve faydası hakkında yeterli olumlu veri bulunmamdığından bu hastalar için en iyi tedavi şeklinin tedaviye tam uyumun sağlaması ve yaşam şekli değişikliği olduğu söylenebilir.

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Cite This Article

AKSU, F., KELEŞ, N., DEMİRCİOĞLU, K., ÇALIŞKAN, M., YILMAZ, Y. (2022). Current approaches to the diagnosis and treatment of resistant hypertension. Medeniyet Medical Journal, Cilt: 31 - Sayı: 3, 213–221. https://ajindex.com/articles/579366

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