Resistant hypertension: a review

Resistant hypertension is currently defined as uncontrolled blood pressure despite the use of optimal doses three antihypertensive medications, which one a diuretic. Several factors have been identified contributors to resistant such poor patient adherence, physician inertia, inadequate or inappropriate combinations drugs, excess alcohol intake, certain drugs and volume overload. Uncontrolled considerable cardiovascular neurological risk factor that can lead possible end-organ consequences untreated hypertension, including heart failure, stroke, ischemic disease renal failure. A comprehensive history physical examination are essential for pointing towards an underlying diagnosis. PubMed search was conducted review articles papers from 1955 2019 containing keywords ‘resistant hypertension’, ‘secondary ‘refractory ‘heart failure’ ‘stroke’, literature compiled. Non-pharmacological measures chiefly include lifestyle modifications smoking cessation, reduction in dietary sodium restriction, healthy eating plans, increased activity weight loss. Among recommended spironolactone beta blockers preferred fourth- fifth-line respectively, patients unresponsive ACE Inhibitors, calcium channel well diuretics. Although most controlled on extended drug regimes, some develop refractory does not even respond five-drug regimen. Interventional therapies denervation carotid sinus stimulation developed with but still require further research follow up ascertain their full potency efficacy.