title: Resistant hypertension: medical management and alternative therapies.
abstract: Resistant hypertension affects 20% to 30% of patients with high blood pressure (BP). It is defined as failure to achieve goal BP despite using at least 3 antihypertensive drugs of different classes, at maximal tolerated doses, one of which must be a diuretic. Persistent suboptimal BP is the most common attributable risk for death worldwide and its prevalence will most likely increase over the next decade. We review the epidemiologic aspects and diagnostic challenges of resistant hypertension, barriers to achieving proper BP control, and causes of secondary hypertension. Lifestyle modification and pharmacologic and device approaches to treatment are discussed.
authors.affiliation: Division of Nephrology, Department of Medicine, Keck School of Medicine, University of Southern California, 2020 Zonal Avenue, IRD 806, Los Angeles, CA 90033, USA.
authors.forename: Hossein
authors.initials: H
authors.lastname: Ghofrani
authors.affiliation: Division of Vascular Surgery & Endovascular Therapy, Department of Surgery, Keck School of Medicine, University of Southern California, 1520 San Pablo Street, Suite 4300, Los Angeles, CA 90033, USA.
authors.forename: Fred A
authors.initials: FA
authors.lastname: Weaver
authors.affiliation: Division of Nephrology, Department of Medicine, Keck School of Medicine, University of Southern California, 1520 San Pablo Street, Suite 4300, Los Angeles, CA 90033, USA. Electronic address: mitra.nadim@med.usc.edu.
authors.forename: Mitra K
authors.initials: MK
authors.lastname: Nadim
mesh_terms: D000368:Aged; D000959:Antihypertensive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D003299:Cooperative Behavior; D003329:Coronary Vasospasm / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000628:therapy*; D003430:Cross-Sectional Studies; D004232:Diuretics / Q000627:therapeutic use; D004305:Dose-Response Relationship, Drug; D004359:Drug Therapy, Combination; D004599:Electric Stimulation Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000628:therapy*; D033183:Interdisciplinary Communication; D007668:Kidney / Q000294:innervation*; D008019:Life Style; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D011311:Pressoreceptors / Q000503:physiopathology; D011379:Prognosis; D013562:Sympathectomy / Q000379:methods*
chemical_list: D000959:Antihypertensive Agents; D004232:Diuretics
keywords: Device; Hypertension; Joint National Committee; Resistant hypertension; Secondary hypertension