title: Management of resistant hypertension: expert consensus statement from the French Society of Hypertension, an affiliate of the French Society of Cardiology.
abstract: To improve the management of resistant hypertension, the French Society of Hypertension, an affiliate of the French Society of Cardiology, has published a set of eleven recommendations. The primary objective is to provide the most up-to-date information based on the strongest scientific rationale and that is easily applicable to daily clinical practice. Resistant hypertension is defined as uncontrolled blood pressure on office measurements and confirmed by out-of-office measurements despite a therapeutic strategy comprising appropriate lifestyle and dietary measures and the concurrent use of three antihypertensive agents including a thiazide diuretic, a renin-angiotensin system blocker (ARB or ACEI) and a calcium channel blocker, for at least 4 weeks, at optimal doses. Treatment compliance must be closely monitored, as must factors that are likely to affect treatment resistance (excessive dietary salt intake, alcohol, depression, drug interactions and vasopressor drugs). If the diagnosis of resistant hypertension is confirmed, the patient should be referred to a hypertension specialist to screen for potential target organ damage and secondary causes of hypertension. The recommended treatment regimen is a combination therapy comprising four treatment classes, including spironolactone (12.5-25 mg per day). In the event of a contraindication or a non-response to spironolactone, or if adverse effects occur, a β-blocker, an α-blocker, or a centrally acting antihypertensive drug should be prescribed. Because renal denervation is still undergoing assessment for the treatment of hypertension, this technique should only be prescribed by a specialist hypertension clinic.
authors.affiliation: Société française d'hypertension artérielle, Paris, France.
authors.forename: T
authors.initials: T
authors.lastname: Denolle
authors.affiliation: Société française d'hypertension artérielle, Paris, France.
authors.forename: B
authors.initials: B
authors.lastname: Chamontin
authors.affiliation: Société française d'hypertension artérielle, Paris, France.
authors.forename: G
authors.initials: G
authors.lastname: Doll
authors.affiliation: Société française d'hypertension artérielle, Paris, France.
authors.forename: J-P
authors.initials: JP
authors.lastname: Fauvel
authors.affiliation: Société française d'hypertension artérielle, Paris, France.
authors.forename: X
authors.initials: X
authors.lastname: Girerd
authors.affiliation: Société française d'hypertension artérielle, Paris, France.
authors.forename: D
authors.initials: D
authors.lastname: Herpin
authors.affiliation: Société française d'hypertension artérielle, Paris, France.
authors.forename: B
authors.initials: B
authors.lastname: Vaïsse
authors.affiliation: Société française d'hypertension artérielle, Paris, France.
authors.forename: F
authors.initials: F
authors.lastname: Villeneuve
authors.affiliation: Société française d'hypertension artérielle, Paris, France.
authors.forename: J M
authors.initials: JM
authors.lastname: Halimi
mesh_terms: D000959:Antihypertensive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects*; D002309:Cardiology / Q000592:standards*; D032921:Consensus; D004351:Drug Resistance; D004359:Drug Therapy, Combination; D019317:Evidence-Based Medicine / Q000592:standards; D005602:France; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology / Q000503:physiopathology; D012307:Risk Factors; D040242:Risk Reduction Behavior; D012955:Societies, Medical / Q000592:standards*; D016896:Treatment Outcome
chemical_list: D000959:Antihypertensive Agents
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