title: The possibility of resistant hypertension during the treatment of hypertensive patients.
abstract: Patients with poorly controlled hypertension despite taking at least three different kinds of anti-hypertensive drugs, including diuretics, are considered to have resistant hypertension (RH). The prevalence of RH was reported to be 13% in the Japanese J-HOME study. The incidences of RH in younger and older Japanese individuals should be prospectively investigated in the near future. RH is associated with poor outcomes and various cardiovascular events. In addition, it is frequently associated with older age, obesity, sleep apnea, long-term hypertension, diabetes, dyslipidemia, reduced renal function, microalbuminuria and left ventricular hypertrophy. Some cases of RH exhibit high levels of aldosterone and cortisol, suggesting that endocrine hypertension should be ruled out among RH patients. Carotid baroreceptor activation and renal sympathetic denervation have recently been developed as treatments for RH. In conclusion, we should consider the possibility of RH during the treatment of hypertensive patients who do not achieve appropriate blood pressure control, in order to avoid the early onset of fatal cardiovascular events and reduce medical costs.
authors.affiliation: Endocrinology and Diabetes Center, Yokohama Rosai Hospital, Yokohama, Japan.
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Nishikawa
authors.forename: Masao
authors.initials: M
authors.lastname: Omura
authors.forename: Jun
authors.initials: J
authors.lastname: Saito
authors.forename: Yoko
authors.initials: Y
authors.lastname: Matsuzawa
mesh_terms: D001794:Blood Pressure; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000453:epidemiology*; D015994:Incidence; D015995:Prevalence; D017211:Treatment Failure