Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2022 Mar 7;11(5):1455.
doi: 10.3390/jcm11051455.

Rethinking Resistant Hypertension

Gabrielle Bourque  1 , Swapnil Hiremath  1
Affiliations
Review

Rethinking Resistant Hypertension

Gabrielle Bourque et al. J Clin Med. .

Abstract

Resistant hypertension is common and known to be a risk factor for cardiovascular events, including stroke, myocardial infarction, heart failure, and cardiovascular mortality, as well as adverse renal events, including chronic kidney disease and end-stage kidney disease. This review will discuss the definition of resistant hypertension as well as the most recent evidence regarding its diagnosis, evaluation, and management. The issue of medication non-adherence and its association with apparent treatment-resistant hypertension will be addressed. Non-pharmacological interventions for the treatment of resistant hypertension will be reviewed. Particular emphasis will be placed on pharmacological interventions, highlighting the role of mineralocorticoid receptor antagonists and sodium-glucose cotransporter-2 inhibitors and device therapy, including renal denervation, baroreceptor activation or modulation, and central arteriovenous fistula creation.

Keywords: adherence; apparent treatment-resistant hypertension; hypertension; mineralocorticoid receptor antagonists; resistant hypertension; review; sodium-glucose cotransporter-2 inhibitors.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no conflict of interest.

References

    1. Fagard R.H. Resistant hypertension. Heart. 2012;98:254–261. doi: 10.1136/heartjnl-2011-300741. - DOI - PubMed
    1. Daugherty S.L., Powers J.D., Magid D.J., Tavel H.M., Masoudi F.A., Margolis K.L., O’Connor P.J., Selby J.V., Ho P.M. Incidence and prognosis of resistant hypertension in hypertensive patients. Circulation. 2012;125:1635–1642. doi: 10.1161/CIRCULATIONAHA.111.068064. - DOI - PMC - PubMed
    1. Tanner R.M., Calhoun D.A., Bell E.K., Bowling C.B., Gutiérrez O.M., Irvin M.R., Lackland D.T., Oparil S., McClellan W., Warnock D.G., et al. Incident ESRD and treatment-resistant hypertension: The reasons for geographic and racial differences in stroke (REGARDS) study. Am. J. Kidney Dis. 2014;63:781–788. doi: 10.1053/j.ajkd.2013.11.016. - DOI - PMC - PubMed
    1. Hiremath S., Sapir-Pichhadze R., Nakhla M., Gabor J.Y., Khan N.A., Kuyper L.M., Ruzicka M., Tobe S.W., Tran K., Rabi D.M., et al. Hypertension Canada’s 2020 Evidence Review and Guidelines for the Management of Resistant Hypertension. Can. J. Cardiol. 2020;36:625–634. doi: 10.1016/j.cjca.2020.02.083. - DOI - PubMed
    1. Rabi D.M., McBrien K.A., Sapir-Pichhadze R., Nakhla M., Ahmed S.B., Dumanski S.M., Butalia S., Leung A.A., Harris K.C., Cloutier L., et al. Hypertension Canada’s 2020 Comprehensive Guidelines for the Prevention, Diagnosis, Risk Assessment, and Treatment of Hypertension in Adults and Children. Can. J Cardiol. 2020;36:596–624. doi: 10.1016/j.cjca.2020.02.086. - DOI - PubMed

LinkOut - more resources