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. 2010 Dec 22:2011:318549.
doi: 10.4061/2011/318549.

Benefits from treatment and control of patients with resistant hypertension

Michael Doumas  1 , Vasilios Papademetriou, Stella Douma, Charles Faselis, Konstantinos Tsioufis, Eugene Gkaliagkousi, Konstantinos Petidis, Chrysanthos Zamboulis
Affiliations

Benefits from treatment and control of patients with resistant hypertension

Michael Doumas et al. Int J Hypertens. .

Abstract

Resistant hypertension is commonly found in everyday clinical practice. However, the risks of resistant hypertension, as well as the benefits of treatment and control of blood pressure in patients with resistant hypertension remain vaguely clarified. Data from small clinical studies and observational cohorts suggest that patients with resistant hypertension are at increased cardiovascular risk, while control of blood pressure offers substantial benefits. It has to be noted however that data from appropriate large randomized studies are missing, and resistant hypertension remains remarkably understudied. Resistant hypertension has attracted significant scientific interest lately, as new therapeutic modalities become available. The interventional management of resistant hypertension either by carotid baroreceptor stimulation or renal sympathetic denervation is currently under investigation with promising preliminary results. This review presents available evidence regarding the benefits of treatment and control of blood pressure in patients with resistant hypertension and offers a critical evaluation of existing data in this field.

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Figures

Figure 1
Figure 1
Five-year mortality rates (%) in untreated patients with malignant hypertension and Grade III or IV retinopathy compared to similar patients that underwent sympathectomy (modified from Keith et al. [25] and Peet et al. [26]).
Figure 2
Figure 2
Survival rates in patients with malignant hypertension at various stages (Group 1–4) treated either medically or surgically (modified from Smithwick and Thompson [39]).
Figure 3
Figure 3
Survival rates in untreated and medically treated patients with malignant hypertension (modified from Harington et al. [40]).
Figure 4
Figure 4
Survival rates in medically treated patients with malignant hypertension according to blood pressure control (modified from Harington et al. [40]).
Figure 5
Figure 5
Probability of event-free survival in patients with resistant hypertension according to daytime diastolic blood pressure (modified from Redon et al. [48]).
See this image and copyright information in PMC

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