Published online Oct 26, 2014. doi: 10.4330/wjc.v6.i10.1080
Revised: April 12, 2014
Accepted: August 27, 2014
Published online: October 26, 2014
Hypertension is one of the most popular fields of research in modern medicine due to its high prevalence and its major impact on cardiovascular risk and consequently on global health. Indeed, about one third of individuals worldwide has hypertension and is under increased long-term risk of myocardial infarction, stroke or cardiovascular death. On the other hand, resistant hypertension, the “uncontrollable” part of arterial hypertension despite appropriate therapy, comprises a much greater menace since long-standing, high levels of blood pressure along with concomitant debilitating entities such as chronic kidney disease and diabetes mellitus create a prominent high cardiovascular risk milieu. However, despite the alarming consequences, resistant hypertension and its effective management still have not received proper scientific attention. Aspects like the exact prevalence and prognosis are yet to be clarified. In an effort to manage patients with resistant hypertension appropriately, clinical doctors are still racking their brains in order to find the best therapeutic algorithm and surmount the substantial difficulties in controlling this clinical entity. This review aims to shed light on the effective management of resistant hypertension and provide practical recommendations for clinicians dealing with such patients.
Core tip: Patients with resistant hypertension are exposed to high cardiovascular risk and proper medical management continues to puzzle clinicians. The appropriate management of resistant hypertension is still elusive. This review provides practical recommendations for the management of resistant hypertension, aiming to help primary care physicians. It also highlights that the therapeutic scheme should always match the patient’s profile in terms of safety, tolerability and effectiveness.