Abstract
Resistant Hypertension (RH) not uncommon in daily clinical practice but is often loosely coined. Accuracy of BP measurement, Adherence to prescribed medications and Adequacy of prescribed dosages are to be ensured before diagnosing RH. Ambulatory blood pressure monitoring and home blood pressure monitoring are becoming standard of care in evaluation of RH patients. Management of RH in recent years has been evolved and spiranolactone has become the fourth drug when combination of Renin-Angiotensin system blockers, calcium channel blockers and long acting thiazide like diuretics fail. Scores like PFK comprising of Urinary pH>7, Female Sex, K<3.5 mg/dl has been handy in decision making to start spiranolactone. However, Refractory Hypertension (RfH) has been defined when five anti-hypertensive drugs including spiranolactone fail and has been emerging to be a novel phenotype. RH patients are known to be volume dependent whereas RfH patients are known to have sympathetic overdrive. Management strategy of RfH is challenging and beta-blockers or alpha-blockers may be of role in these subset. Renal artery denervation is being resurrected with newer evidence and definitely an option for RfH patients. Novel therapies like Barroreceptor Activation Techniques and Central iliac arteriovenous anastomosis are being evaluated in resistant and refractory hypertension patients.
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callMore From: Journal of the Practice of Cardiovascular Sciences
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
