How common is true resistant hypertension?

Abstract

Resistant hypertension, defined as failure to achieve goal blood pressures in patients taking optimal or maximum tolerated doses of three or more antihypertensive drugs, is estimated to occur in about 25% of hypertensive patients on treatment. Poor adherence with treatment is considered to have an important role leading to apparent drug resistant hypertension. We have demonstrated that observed drug taking ('tablet feed'), followed by close monitoring of blood pressure in a clinic environment, together with ambulatory blood pressure monitoring, identifies a high proportion of patients (about two-thirds) of those presenting with resistant hypertension, whose persistently elevated blood pressure levels are due to poor adherence with drug treatment.