In India cardiovascular diseases (CVD) are epidemic and the largest cause of deaths. The Million Death Study in India reported that in years 2000-2003 CVD’s caused 20% of the more than 10.5 million annual deaths. The absolute numbers of deaths (about 2.1 million) are highest in the world and significantly greater than USA and other large countries1. Major CVD risk factors are as important in In...

Resistant hypertension (RH) is defined as blood pressure that remains above target in spite of the concurrent use of three or more classes of antihypertensive drugs at optimized doses (UCRH), with one of them being a diuretic. Moreover, patients whose blood pressure is controlled while using four or more antihypertensive medications are also considered controlled resistant hypertensive (CRH) su...

Callus R, et al. BMJ Case Rep 2017. doi:10.1136/bcr-2017-220307 Description A 50-year-old man with known hypertension, diabetes controlled on diet and end-stage kidney disease of unknown aetiology received a donor after brain death renal allograft from an extended criteria donor. There was initial delayed graft function, followed by a reduction in serum creatinine to a nadir of 115 μmol/L. Main...

1Vascular Risk Area. Hospital Moisès BroggiConsorci Sanitgari Integral, University of Barcelona, Spain 2Department of Internal MedicineHospital Moisès BroggiConsorci Sanitari Integral, University of Barcelona, Spain 3Department of Cardiology -Hospital Moisès BroggiConsorci Sanitari Integral, University of Barcelona, Spain 4Department of NephrologyHospital Moisès BroggiConsorci Sanitari Integral...

The following definition of resistant hypertension is proposed: Provided that adherence to the regimen can be assured, hypertension should be considered resistant if the blood pressure cannot be reduced to less than 150/100 mm Hg by a rational triple drug regimen, including a diuretic, prescribed in nearly maximal doses and if the pretreatment blood pressure was greater than or equal to 180/115...

Pharmacologic therapy for hypertension is effective for the majo rity of patients with hypertension, but there remains a subset of the population with treatment resistant hypertension who cannot achieve their blood pressure (BP) goal despite multiple medications. For these patients at increased risk of cardio vascular disease and end-organ damage, additional therapies need to be considered. Thi...

Enhanced target organ damage and cardiovascular morbidity represent common issues observed in both resistant hypertension and obstructive sleep apnea. Common pathophysiological features and risk factors justify their coexistence, especially in individuals with increased upper-body adiposity. Impaired sodium handling, sympathetic activation, accelerated arterial stiffening, and impaired cardiore...

In patients with hypertension resistant to three or four drugs including a thiazide diuretic substitution of frusemide for the thiazide, or the addition of spironolactone, produced significant reductions in blood pressure and body weight. The response did not depend on the presence of overt fluid retention, renal impairment, or the use of antihypertensive drugs of high potency. Women had larger...

AIMS The effect of resistant hypertension on outcomes in patients with atherothrombotic disease is currently unknown. Accordingly, we sought to determine the prevalence and outcomes of resistant hypertension in stable hypertensive outpatients with subclinical or established atherothombotic disease enrolled in the international Reduction of Atherothrombosis for Continued Health (REACH) registry....