Resistant hypertension (RH) occurs when a patient’s blood pressure (BP) above 130/80 mmHg even after intensive hypertension treatment, which includes using 3 concurrent anti-hypertensive medication classes of drug regularly, such as:

  • Calcium channel blocker: amlodipine or nifedipine
  • Renin-angiotensin system blocker: lisinopril or ramipril
  • Angiotensin receptor blocker: losartan or valsartan
  • Diuretic: hydrochlorothiazide or chlorthalidone

If after properly administering the daily doses of antihypertensive medications your condition has not improved, your doctor will work with you to determine if you have resistant hypertension and how to control this condition.

Diagnosing and Managing Resistant Hypertension

Resistant hypertension can have several causes and your physician will require a complete evaluation to identify any underlying conditions or secondary causes of hypertension, including:

  • Lifestyle choices (including excessive salt or alcohol ingestion, smoking)
  • Sleep apnea or other sleeping problems
  • Kidney disease
  • Atherosclerosis (narrowed arteries due to plague)
  • Hormone abnormalities (such as hyperaldosteronism, hyperthyroidism, hypothyroidism and more)
  • Obesity

Patients who do not seek treatment for resistant hypertension can run the risk of kidney damage, stroke, heart attack and more. Understanding what is causing your resistant hypertension will allow your doctor to personalize your treatment plan to improve your results.

Continued Research

The University of Chicago Medicine is a central site that studies interventional techniques that help reduce blood pressure in people who do not get significant reductions from medications alone. Moreover, the Director of the AHA Comprehensive Hypertension Center was an author of the updated Consensus Report on treatment of resistant hypertension.