JCCVS
Journal of Cardiology & Cardiovascular Surgery

Journal of Cardiology & Cardiovascular Surgery scientific, open-access, double-blind peer-reviewed journal covering a wide spectrum of topics in cardiology and cardiovascular surgery. This journal is indexed by indices that are considered international scientific journal indices (DRJI, ESJI, OAJI, etc.). According to the current Associate Professorship criteria, it is within the scope of International Article 1-d. Each article published in this journal corresponds to 5 points.

eISSN: 2980-1397
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Review
Current approach to resistant hypertension
Abstract
Resistant hypertension is the inability to achieve target blood pressure (<130/80 mmHg) despite using the maximum tolerated doses of three antihypertensive drugs, including a diuretic, or the need for four or more medications. It is linked to aging, obesity, obstructive sleep apnea, and chronic kidney disease, with contributing factors such as high sodium intake and sympathetic nervous system overactivity. Treatment includes optimizing diuretic use, with spironolactone proving highly effective. Lifestyle modifications, including sodium reduction and exercise, are critical. Emerging therapies like renal denervation offer promising long-term blood pressure control.

Keywords : Resistant hypertension, sympathetic nervous system, diuretic, renal denervation

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1. McEvoy JW, McCarthy CP, Bruno RM, et al. 2024 ESC Guidelines forthe management of elevated blood pressure and hypertension. EurHeart J. 2024:ehae178. doi: 10.1093/eurheartj/ehae178
2. Whelton PK, Carey RM, Aronow WS, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ ASPC/NMA/PCNA Guideline for thePrevention, Detection, Evaluation, and Management of High BloodPressure in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical PracticeGuidelines. J Am Coll Cardiol. 2018;71(19):e127-e248. doi: 10.1016/j.jacc.2017.11.006
3. Mittal S, Jain P, Sharma R, et al. Approaches in managing resistanthypertension: a review. Cureus. 2024 Apr 8;16(4):e57804. doi: 10.7759/cureus.57804
4. Calhoun DA, Jones D, Textor S, et al. Resistant hypertension: diagnosis,evaluation, and treatment. A scientific statement from the AmericanHeart Association Professional Education Committee of the Councilfor High Blood Pressure Research. Hypertension. 2008;51(6):1403-19.doi: 10.1161/HYPERTENSIONAHA.108.189141
5. Sarafidis PA, Bakris GL. Resistant hypertension: an overview ofevaluation and treatment. J Am Coll Cardiol. 2008;52(22):1749-57. doi:10.1016/j.jacc.2008.08.036
6. Yahr J, Thomas G, Calle J, Taliercio JJ. Resistant hypertension: astepwise approach. Cleve Clin J Med. 2023;90(2):115-125. doi: 10.3949/ccjm.90a.22046
7. Pimenta E, Gaddam KK, Oparil S. Mechanisms and treatment ofresistant hypertension. J Clin Hypertens (Greenwich). 2008;10(3):239-44. doi: 10.1111/j.1751-7176.2008.08143.x
8. Ghazi L, Oparil S, Calhoun DA, Lin CP, Dudenbostel T. Distinctive riskfactors and phenotype of younger patients with resistant hypertension:age is relevant. Hypertension. 2017;69(5):827-835. doi: 10.1161/HYPERTENSIONAHA.116.08632
9. Badila E, Japie C, Weiss E, Balahura AM, Barto? D, Scafa Udri?te A.The road to better management in resistant hypertension-diagnosticand therapeutic insights. Pharmaceutics. 2021;13(5):714. doi: 10.3390/pharmaceutics13050714
10. Siddiqui M, Calhoun DA. Refractory versus resistant hypertension.Curr Opin Nephrol Hypertens. 2017;26(1):14-19. doi: 10.1097/MNH.0000000000000286
11. Eide IK, Torjesen PA, Drolsum A, Babovic A, Lilledahl NP. Low-reninstatus in therapy-resistant hypertension: a clue to efficient treatment.J Hypertens. 2004;22(11):2217-26. doi: 10.1097/ 00004872-200411000-00026
12. Buso G, Agabiti-Rosei C, Lemoli M, Corvini F, Muiesan ML. The globalburden of resistant hypertension and potential treatment options. EurCardiol. 2024;19:e07. doi: 10.15420/ecr.2023.51
13. Mancia G, Kreutz R, Brunstr&ouml;m M, et al. 2023 ESH Guidelines forthe management of arterial hypertension The Task Force for themanagement of arterial hypertension of the European Society ofHypertension: Endorsed by the International Society of Hypertension(ISH) and the European Renal Association (ERA). J Hypertens.2023;41(12):1874-2071. doi: 10.1097/HJH.0000000000003480
14. Vongpatanasin W. Resistant hypertension: a review of diagnosis andmanagement. JAMA. 2014;311(21):2216-24. doi: 10.1001/jama.2014.5180
15. Saneei P, Salehi-Abargouei A, Esmaillzadeh A, Azadbakht L. Influenceof Dietary Approaches to Stop Hypertension (DASH) diet on bloodpressure: a systematic review and meta-analysis on randomizedcontrolled trials. Nutr Metab Cardiovasc Dis. 2014;24(12):1253-61. doi:10.1016/j. numecd.2014.06.008
16. Moser M, Setaro JF. Clinical practice. Resistant or difficult-to-control hypertension. N Engl J Med. 2006;355(4):385-92. doi: 10.1056/NEJMcp041698
17. Garg JP, Elliott WJ, Folker A, Izhar M, Black HR; RUSH UniversityHypertension Service. Resistant hypertension revisited: a comparisonof two university-based cohorts. Am J Hypertens. 2005;18(5 Pt 1):619-26. doi: 10.1016/j.amjhyper.2004.11.021
18. Peterzan MA, Hardy R, Chaturvedi N, Hughes AD. Meta-analysis of dose-response relationships for hydrochlorothiazide,chlorthalidone, and bendroflumethiazide on blood pressure, serumpotassium, and urate. Hypertension. 2012;59(6):1104-9. doi: 10.1161/HYPERTENSIONAHA.111.190637
19. Williams B, MacDonald TM, Morant S, et al. Spironolactone versusplacebo, bisoprolol, and doxazosin to determine the optimal treatmentfor drug- resistant hypertension (PATHWAY-2): a randomised, double-blind, crossover trial. Lancet. 2015;386(10008):2059-2068. doi: 10.1016/S0140-6736(15)00257-3
20. Tian Z, Vollmer Barbosa C, Lang H, Bauersachs J, Melk A, SchmidtBMW. Efficacy of pharmacological and interventional treatment forresistant hypertension: a network meta-analysis. Cardiovasc Res. 2024Feb 27;120(1):108-119. doi: 10.1093/cvr/cvad165
21. Georgianos PI, Agarwal R. Ambulatory blood pressure reductionwith SGLT-2 inhibitors: dose-response meta-analysis and comparativeevaluation with low-dose hydrochlorothiazide. Diabetes Care.2019;42(4):693-700. doi: 10.2337/dc18-2207
22. DiBona GF. Sympathetic nervous system and hypertension.Hypertension. 2013;61(3):556-60. doi: 10.1161/HYPERTENSIONAHA.111.00633
23. Iliescu R, Lohmeier TE, Tudorancea I, Laffin L, Bakris GL. Renaldenervation for the treatment of resistant hypertension: review andclinical perspective. Am J Physiol Renal Physiol. 2015;309(7):F583-94.doi: 10.1152/ajprenal.00246.2015
24. Rader F, Kirtane AJ, Wang Y, et al. Durability of blood pressurereduction after ultrasound renal denervation: three-year follow-up ofthe treatment arm of the randomised RADIANCE-HTN SOLO trial.EuroIntervention. 2022;18(8):e677-e685. doi: 10.4244/EIJ-D-22-00305
25. Curneen JMG, Rabbitt L, Browne D, et al. Major disparities in patient-reported adherence compared to objective assessment of adherenceusing mass spectrometry: a prospective study in a tertiary-referralhypertension clinic. Br J Clin Pharmacol. 2023;89(7):1948-1955. doi:10.1111/bcp.15292
Article available in :
Volume 2, Issue 3, 2024
Page : 53-55
https://doi.org/10.51271/JCCVS-0037
Article Information
Received : 16 Eyl 2024
Accepted : 28 Eyl 2024
Published : 30 Eyl 2024
Corresponding Author :

Çelebi Yıldırım: Department of Internal Medicine, Phoenexville Hospital Towerhealth, Phoenixville, PA, USA

[email protected]
Citation : Yıldırım Ç, Chaudhry A, Basrak MT, Aksu Ç, Karataş M, Digregorio A. Current approach to resistant hypertension. J Cardiol Cardiovasc Surg. 2024;2(3):53-55.

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