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Review
. 2009 May;25(5):315-7.
doi: 10.1016/s0828-282x(09)70496-9.

Resistant hypertension

Sheldon W Tobe  1 , Richard Lewanczuk
Affiliations
Review

Resistant hypertension

Sheldon W Tobe et al. Can J Cardiol. 2009 May.

Abstract
in English, French

Resistant hypertension is most often due to insufficient medical therapy. With a patient history, physical examination and focused laboratory tests, sufficient information can be gathered to lead to further directed medical therapy, which most often includes a diuretic as part of the drug regimen. Patients may require four or more classes of antihypertensives, some at high doses to achieve control. The clinician must be prepared to use sufficient medications at sufficient doses to achieve blood pressure targets. Referral to a hypertension specialist is appropriate if blood pressure remains uncontrolled despite therapy with three antihypertensive medications.

L’hypertension rebelle est le plus souvent attribuable à un traitement médicamenteux insuffisant. À partir de l’anamnèse, de l’examen physique et d’analyses de laboratoire ciblées, on peut obtenir assez d’informations pour orienter le traitement médicamenteux, qui inclut souvent, entre autre, un diurétique. Pour obtenir une bonne maîtrise de leur TA, les patients peuvent avoir besoin de quatre classes différentes d’antihypertenseurs ou plus, parfois à doses élevées. Le médecin doit être préparé à utiliser suffisamment de médicaments aux doses adéquates pour obtenir les chiffres tensionnels visés. On adressera le patient à un spécialiste de l’hypertension si sa TA demeure incontrôlée malgré un traitement comprenant trois antihypertenseurs.

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