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Common Secondary Causes of Resistant Hypertension and Rational for Treatment

Resistant hypertension is defined as uncontrolled blood pressure despite the use of three antihypertensive drugs, including a diuretic, in optimal doses. Treatment resistance can be attributed to poor adherence to antihypertensive drugs, excessive salt intake, physician inertia, inappropriate or ina...

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Detalles Bibliográficos
Autores principales: Faselis, Charles, Doumas, Michael, Papademetriou, Vasilios
Formato: Texto
Lenguaje:English
Publicado: SAGE-Hindawi Access to Research 2011
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3057025/
https://www.ncbi.nlm.nih.gov/pubmed/21423678
http://dx.doi.org/10.4061/2011/236239
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author Faselis, Charles
Doumas, Michael
Papademetriou, Vasilios
author_facet Faselis, Charles
Doumas, Michael
Papademetriou, Vasilios
author_sort Faselis, Charles
collection PubMed
description Resistant hypertension is defined as uncontrolled blood pressure despite the use of three antihypertensive drugs, including a diuretic, in optimal doses. Treatment resistance can be attributed to poor adherence to antihypertensive drugs, excessive salt intake, physician inertia, inappropriate or inadequate medication, and secondary hypertension. Drug-induced hypertension, obstructive sleep apnoea, primary aldosteronism, and chronic kidney disease represent the most common secondary causes of resistant hypertension. Several drugs can induce or exacerbate pre-existing hypertension, with non-steroidal anti-inflammatory drugs being the most common due to their wide use. Obstructive sleep apnoea and primary aldosteronism are frequently encountered in patients with resistant hypertension and require expert management. Hypertension is commonly found in patients with chronic kidney disease and is frequently resistant to treatment, while the management of renovascular hypertension remains controversial. A step-by-step approach of patients with resistant hypertension is proposed at the end of this review paper.
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spelling pubmed-30570252011-03-21 Common Secondary Causes of Resistant Hypertension and Rational for Treatment Faselis, Charles Doumas, Michael Papademetriou, Vasilios Int J Hypertens Review Article Resistant hypertension is defined as uncontrolled blood pressure despite the use of three antihypertensive drugs, including a diuretic, in optimal doses. Treatment resistance can be attributed to poor adherence to antihypertensive drugs, excessive salt intake, physician inertia, inappropriate or inadequate medication, and secondary hypertension. Drug-induced hypertension, obstructive sleep apnoea, primary aldosteronism, and chronic kidney disease represent the most common secondary causes of resistant hypertension. Several drugs can induce or exacerbate pre-existing hypertension, with non-steroidal anti-inflammatory drugs being the most common due to their wide use. Obstructive sleep apnoea and primary aldosteronism are frequently encountered in patients with resistant hypertension and require expert management. Hypertension is commonly found in patients with chronic kidney disease and is frequently resistant to treatment, while the management of renovascular hypertension remains controversial. A step-by-step approach of patients with resistant hypertension is proposed at the end of this review paper. SAGE-Hindawi Access to Research 2011-03-02 /pmc/articles/PMC3057025/ /pubmed/21423678 http://dx.doi.org/10.4061/2011/236239 Text en Copyright © 2011 Charles Faselis et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Review Article
Faselis, Charles
Doumas, Michael
Papademetriou, Vasilios
Common Secondary Causes of Resistant Hypertension and Rational for Treatment
title Common Secondary Causes of Resistant Hypertension and Rational for Treatment
title_full Common Secondary Causes of Resistant Hypertension and Rational for Treatment
title_fullStr Common Secondary Causes of Resistant Hypertension and Rational for Treatment
title_full_unstemmed Common Secondary Causes of Resistant Hypertension and Rational for Treatment
title_short Common Secondary Causes of Resistant Hypertension and Rational for Treatment
title_sort common secondary causes of resistant hypertension and rational for treatment
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3057025/
https://www.ncbi.nlm.nih.gov/pubmed/21423678
http://dx.doi.org/10.4061/2011/236239
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