Interní Med. 2009; 11(4): 159-162 [Med. Pro Praxi 2008; 5(10): 354-357]

Clinical characteristics, diagnostic aspects, prevention, and treatment of resistant hypertension

prof. MUDr. Jaroslav Šimon DrSc

Centrum preventivní kardiologie, II. interní klinika LF UK Plzeň

Resistant hypertension is a commonly occurring clinical phenomenon in both general and specialized practice. The prevalence is not

precisely known, with elderly persons, obese individuals, and those with metabolic syndrome being more frequently affected. Occasional

elevations in blood pressure due to psychosomatic causes and in anxiety and panic episodes need to be distinguished. Permanent

resistance requires ambulatory monitoring of blood pressure and an intensive search for a secondary cause of hypertension. Initial

interventions should involve lifestyle modifications. Pharmacological treatment consists in triple or quadruple combinations of drugs

based on the guidelines and the administration of sufficient doses of diuretics. The addition of low doses of spironolactone has proved

beneficial in some cases.

Keywords: resistant hypertension, pseudohypertension, white coat hypertension.

Published: June 1, 2009  Show citation