Newer alternatives for resistant hypertension: Beyond 2022 paradigms
Author(s): Professor. George Bakris
Resistant hypertension (RH) is defined as office systolic blood pressure (SBP) ³130mmHg or diastolic blood pressure (DBP) ³80mmHg while receiving at least three antihypertensive medications at maximally tolerated doses, one of which is a thiazide-type diuretic.1,2 Despite the more than 100 medications approved to treat hypertension, the prevalence of RH is estimated to be 13.7% (95% CI, 11.2-16.2%) based on a meta-analysis of 20 observational studies.3 However it is imperative to exclude “apparent from true resistant hypertension” by evaluating medication adherence, accurate office blood pressures, and ambulatory blood pressures.1 Patients with actual RH are at a significantly increased risk for cardiovascular mortality and worsening of kidney function compared to hypertensive patients without RH.4
There are five different classes of antihypertensive medications being developed for resistant or difficult-to-treat hypertension, as well as renal denervation, by two different methods. These are briefly discussed.
View PDF View Fulltext