High Pressure, Low Control: The Challenging Side Of Resistant Arterial Hypertension
DOI:
https://doi.org/10.58043/rphrc.155Keywords:
Resistant Arterial Hypertension, Pharmacological Resistance, Treatment, New Therapeutic AlternativesAbstract
Arterial hypertension constitutes a highly prevalent cardiovascular risk factor in the global population. However, a significant portion of patients fails to achieve adequate blood pressure levels for effective risk control, challenging medical practice. Resistant hypertension is identified when the patient maintains blood pressure levels above the recommended value, even with the concurrent use of three anti-hypertensive medications at optimized doses, one of which is a diuretic. This clinical case illustrates a case of resistant arterial hypertension and the various therapeutic approaches used in blood pressure control.Downloads
References
James P, Oparil S, Carter B, Cushman W, Dennison-Himmelfarb C, Handler J, et al. 2014 Evidence-based guidelines for the management of high blood pressure in adults; Report from the panel members appointed to the eighth joint national committee ( JNC 8). JAMA 2014;311:507-20.
Pimenta E, Calhoun D. Treatment of resistant hypertension. J Hypertension 2010;28:2194-5.
Michel Azizi, MD; Manish Saxena, MBBS, MSc; Yale Wang, MD; et al. Endovascular Ultrasound Renal Denervation to Treat Hypertension. The RADIANCE II Randomized Clinical Trial. AMA. 2023;329(8):651-661.
Prof Felix Mahfoud, MD; David E Kandzari, MD; Prof Kazuomi Kario, MD; Prof Raymond R Townsend, MD; Prof Michael A Weber, MD; Prof Roland E Schmieder, MD; et al. L ong-term efficacy and safety of renal denervation in the presence of antihypertensive drugs (SPYRAL HTN-ON MED): a randomised, sham-controlled trial. The Lancet. 2022; 399:1401-1410.
Bhatt D, Kandzari D, O’Neil W, D’Agostino R, Flack J, Katzen B, et al. A controlled trial of renal denervation for Journal of Family Medicine and Primary Care resistant hypertension. N Engl J Med 2014;370:1393-401.
Bisognano J, Bakris G, Nadim M, Sanchez L, Kroon A, Schafer J, et al. Baroreflex activation therapy lowers blood pressure in patients with resistant hypertension; results from the double blind, randomised, placebo-controlled Rheos Pivotal Trial. J Am Coll Cardiol 2011;58:765-73.
Luke J. Laffin, MD1,2; David Rodman, MD3; James M. Luther, MD4; et al. Aldosterone Synthase Inhibition With Lorundrostat for Uncontrolled Hypertension. The Target-HTN Randomized Clinical Trial. JAMA. 2023;330(12):1140-1150.
Akshay S. Desai, M.D., M.P.H., David J. Webb, M.D., D.Sc., Jorg Taubel, M.D., Sarah Casey, M.B., Ch.B., Yansong Cheng, Ph.D., Gabriel J. Robbie, Ph.D., Don Foster, M.S., Stephen A. Huang, M.D., Sean Rhyee, M.D., M.P.H., Marianne T. Sweetser, M.D., Ph.D., and George L. Bakris, M.D. Zilebesiran, an RNA Interference Therapeutic Agent for Hypertension. N Engl J Med 2023; 389:228-238.
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Copyright (c) 2025 Mariana Caetano Coelho
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