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Resistant Hypertension: Novel Insights

Current hypertension reviews, 2020-01, Vol.16 (1), p.61 [Peer Reviewed Journal]

Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net. ;Distributed under a Creative Commons Attribution 4.0 International License ;ISSN: 1573-4021 ;EISSN: 1875-6506 ;DOI: 10.2174/1573402115666191011111402 ;PMID: 31622203

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Title:
Resistant Hypertension: Novel Insights
Author: Lamirault, Guillaume ; Artifoni, Mathieu ; Daniel, Mélanie ; Barber-Chamoux, Nicolas ; Nantes University Hospital Working Group On Hypertension
Subjects: Antihypertensive Agents - therapeutic use ; Arteriovenous Shunt, Surgical ; Blood Pressure - drug effects ; Drug Resistance ; Drug Therapy, Combination ; Electric Stimulation Therapy ; Humans ; Hypertension - diagnosis ; Hypertension - drug therapy ; Hypertension - epidemiology ; Hypertension - physiopathology ; Life Sciences ; Medication Adherence ; Risk Factors ; Sympathectomy ; Treatment Outcome ; White Coat Hypertension - diagnosis ; White Coat Hypertension - epidemiology ; White Coat Hypertension - physiopathology
Is Part Of: Current hypertension reviews, 2020-01, Vol.16 (1), p.61
Description: Hypertension is the most common chronic disease and the leading risk factor for disability and premature deaths in the world, accounting for more than 9 million deaths annually. Resistant hypertension is a particularly severe form of hypertension. It was described 50 years ago and since then has been a very active field of research. This review aims at summarizing the most recent findings on resistant hypertension. The recent concepts of apparent- and true-resistant hypertension have stimulated a more precise definition of resistant hypertension taking into account not only the accuracy of blood pressure measurement and pharmacological class of prescribed drugs but also patient adherence to drugs and life-style recommendations. Recent epidemiological studies have reported a 10% prevalence of resistant hypertension among hypertensive subjects and demonstrated the high cardiovascular risk of these patients. In addition, these studies identified subgroups of patients with even higher morbidity and mortality risk, probably requiring a more aggressive medical management. In the meantime, guidelines provided more standardized clinical work-up to identify potentially reversible causes for resistant hypertension such as secondary hypertension. The debate is however still ongoing on which would be the optimal method(s) to screen for non-adherence to hypertension therapy, recognized as the major cause for (pseudo)-resistance to treatment. Recent randomized clinical trials have demonstrated the strong benefit of anti-aldosterone drugs (mostly spironolocatone) as fourth-line therapies in resistant hypertension whereas clinical trials with device-based therapies displayed contrasting results. New trials with improved devices and more carefully selected patients with resistant hypertension are ongoing.
Publisher: United Arab Emirates: Bentham Science Publishers
Language: English
Identifier: ISSN: 1573-4021
EISSN: 1875-6506
DOI: 10.2174/1573402115666191011111402
PMID: 31622203
Source: Hyper Article en Ligne (HAL) (Open Access)

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Resistant Hypertension: Novel Insights

Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net. ;Distributed under a Creative Commons Attribution 4.0 International License ;ISSN: 1573-4021 ;EISSN: 1875-6506 ;DOI: 10.2174/1573402115666191011111402 ;PMID: 31622203

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