Antihypertensive Bridge Therapy by Continuous Drug Infusion With an Elastomeric Pump in Device-Resistant Hypertension.

To the Editor: Over recent years, invasive hypertension treatments have led to a new clinical condition, called device-resistant hypertension (DRH).1 DRH is defined as blood pressure (BP) >140/90 mm Hg, with at least 3 antihypertensives at maximal doses, including a diuretic,2 without BP decrease after the invasive treatments. These patients are not infrequent and are obliged to visit several hypertension units for managing their BP. We have observed a significant BP decrease only by using intravenous drugs recommended for emergencies.2,3 Thus, we refined a protocol to perform a chronic intravenous antihypertensive infusion in patients with DRH via an elastomeric pump and a peripherally inserted central catheter (PICC). After exclusion of several intravenous drugs for contraindications, urapidil was selected as the drug of choice. Here, we present the case of the first treated patient with DRH.