Document Detail


Reduction of blood pressure in patients with treatment-resistant hypertension.
MedLine Citation:
PMID:  19925047     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Resistant hypertension is a common clinical problem, and patients with resistant hypertension have increased cardiovascular risk. It is a subset of the hypertensive population that is little studied and poorly characterized. OBJECTIVE: The purpose of this review is to discuss resistant hypertension, its recognition and diagnostic workup and management, and to present current data about the disease from the latest research. METHODS: We define resistant hypertension and differentiate it from pseudoresistance. We identify diagnostic tests that may be done on patients with resistant hypertension. Last, we discuss therapeutic approaches to resistant hypertension, focusing on pharmacological treatment, and present an algorithm that may be used by the clinician in treating a patient with resistant hypertension. CONCLUSION: Resistant hypertension is a significant clinical problem commonly encountered by clinicians. Patients with resistant hypertension have increased cardiovascular risk. In evaluating for resistant hypertension, it is important to recognize elements that contribute to pseudoresistance to treatment. Secondary causes of hypertension are common in patients with resistant hypertension and should be included in the diagnostic workup. Pharmacological treatment for resistant hypertension entails choosing medications with complementary mechanisms of action, optimizing diuretic use, and considering the use of mineralocorticoid antagonists as an add-on agent to the antihypertensive regimen.
Authors:
Maria Czarina Acelajado; David A Calhoun; Suzanne Oparil
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Expert opinion on pharmacotherapy     Volume:  10     ISSN:  1744-7666     ISO Abbreviation:  Expert Opin Pharmacother     Publication Date:  2009 Dec 
Date Detail:
Created Date:  2009-12-03     Completed Date:  2010-02-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100897346     Medline TA:  Expert Opin Pharmacother     Country:  England    
Other Details:
Languages:  eng     Pagination:  2959-71     Citation Subset:  IM    
Affiliation:
University of Alabama at Birmingham, 35294-2041, USA. czarina.acelajado@ccc.uab.edu
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MeSH Terms
Descriptor/Qualifier:
Algorithms
Antihypertensive Agents / pharmacology,  therapeutic use*
Drug Resistance
Humans
Hypertension / diagnosis,  drug therapy*,  etiology
Chemical
Reg. No./Substance:
0/Antihypertensive Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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