Resistant hypertension (high blood pressure) is when a person has made the appropriate lifestyle changes in order to reduce their blood pressure or have taken at least two different types of blood pressure-lowering medications, and yet their blood pressure has not improved. Essentially, resistant hypertension refers to blood pressure that is difficult to treat and that may result from an underlying cause.
Possible causes for resistant hypertension include abnormalities in hormones controlling blood pressure, accumulation of artery-clogging plaque in the vessels that provide nutrients to the kidneys, sleep problems like sleep apnea, obesity, or high alcohol consumption.
Managing resistant hypertension patients
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A review of articles on resistant hypertension uncovered new ways for physicians to help patients with hard-to-treat high blood pressure. Researcher Dr. Raj Padwal and colleagues wrote, “We found few randomized controlled trials (RCTs) and no systematic reviews to guide decision-making. Thus, we have made management recommendations based primarily on expert consensus, unless otherwise specified.”
The study found that before targeting resistant hypertension, physicians should rule out pseudoresistance, which consists of higher blood pressure when visiting a doctor (known as the white coat effect), failure to take medications as instructed, and inaccurate blood pressure readings.
The study recommends the following for improving treatment of resistant hypertension:
- Optimizing current medications and improving adherence.
- Counseling patients on reduced salt intake, lower alcohol use, exercise, and a healthy weight.
- Treating obstructive sleep apnea with a CPAP device.
- Adding drugs when current ones are ineffective.
- Referring patients to hypertension specialists.
The researchers recommend that more studies need to be conducted on resistant hypertension in order to better understand this condition and improve treatments.
Strategy to help manage resistant hypertension
Resistant hypertension may be difficult to treat, but it’s still important that patients partake in the healthy lifestyle habits to help reduce high blood pressure, along with taking at least three different medications.
Lifestyle choices for treating hypertension include eating a healthy diet, reducing sodium and alcohol intake, controlling your weight, exercising, not smoking, reducing stress, and treating any sleep conditions such as sleep apnea.
Emily Lunardo studied medical sociology at York University with a strong focus on the social determinants of health and mental illness. She is a registered Zumba instructor, as well as a Canfit Pro trainer, who teaches fitness classes on a weekly basis. Emily practices healthy habits in her own life as well as helps others with their own personal health goals. Emily joined Bel Marra Health as a health writer in 2013.
