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World J Hypertens. Mar 12, 2019; 9(1): 1-16
Published online Mar 12, 2019. doi: 10.5494/wjh.v9.i1.1
Achieving control of resistant hypertension: Not just the number of blood pressure medications
Kara Schmidt, William Kelley, Steven Tringali, Jian Huang
Kara Schmidt, William Kelley, Steven Tringali, Jian Huang, Department of Internal Medicine, University of California San Francisco-Fresno Medical Education Program, Fresno, CA 93701, United States
Jian Huang, Medicine Service, VA Central California Health Care System, Fresno, CA 93703, United States
Author contributions: Schmidt K and Kelley W worked in equal parts in the drafting of the body of the manuscript; Schmidt K wrote the abstract, designed the figures, and contributed to formatting and submission; concept design and editing were done by Tringali S and Huang J.
Conflict-of-interest statement: No potential conflicts of interest relevant to this article were reported.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Jian Huang, FACP, MD, Professor, Department of Internal Medicine, University of California San Francisco-Fresno Medical Education Program, 2615 E Clinton Ave, Fresno, CA 93701, United States. jian.huang@va.gov
Telephone: +1-559-2256100 Fax: +1-559-2416484
Received: November 14, 2018
Peer-review started: November 14, 2018
First decision: December 5, 2018
Revised: January 11, 2019
Accepted: January 21, 2019
Article in press: January 22, 2019
Published online: March 12, 2019
Core Tip

Core tip: Resistant hypertension (RH) is associated with an increased risk of cardiovascular events as well as mortality. Updated American College of Cardiology and American Heart Association guidelines in 2017 promote the use of mineralocorticoid receptor antagonists, which is a major change from prior guidelines. Device-based therapies such as renal denervation and carotid baroreceptor activation have emerged as innovative treatment modalities. They are continuing to be refined to improve their safety as well as efficacy profiles. Overall more validation is needed for device-based therapies, especially in the RH population.