Presentation
The patient was discharged and was lost to follow-up until he presented again in 2012 for 'resistant hypertension' in our outpatient clinic. [ncbi.nlm.nih.gov]
Entire Body System
- Fatigue
After the initial visit, the patient presented to the clinic with complaints of dizziness and fatigue and was found to be hypotensive. [ncbi.nlm.nih.gov]
He reports compliance with his medication regimen, and does not report any specific intolerances that he attributes to medications, but does note that he has a dry mouth, feels fatigued, and has excessive daytime sleepiness. Continue [clevelandclinicmeded.com]
Have your blood pressure and blood glucose levels tested regularly and see a kidney specialist if you experience fluid retention in your legs, ankles, feet or face; have unexplained fatigue, headache, nausea or vomiting. [mainlinehealth.org]
As an aside, the fatigue and dry mouth were attributed to the β-blocker and the alpha 2 -agonist, supporting the adherence he claimed to his BP regimen. [cjasn.asnjournals.org]
Martínez-Lavín, “Sympathetic nervous system dysfunction in fibromyalgia, chronic fatigue syndrome, irritable bowel syndrome, and interstitial cystitis: a review of case-control studies.,” J. Clin. Rheumatol., vol. 20, no. 3, pp. 146–50, Apr. 2014. [acta.tums.ac.ir]
- Inflammation
[…] of the eyelids), dry eye, ocular hyperaemia (red eye), eye pruritis (itching), arthralgia (joint pain) and nasopharyngitis (inflammation of the nose and throat sv Jag såg honom vid sjukhuset [sv.glosbe.com]
We investigated whether Southern Italy resistant hypertensives presented an association between the presence of I and/or D alleles and early vascular damage, inflammation, and insulin resistance. [ncbi.nlm.nih.gov]
Conclusion: The metabolites altered in RH are linked to oxidative stress and inflammation, endothelium dysfunction, vasoconstriction, and cell proliferation. Our results may generate new hypothesis about RH development and progression. [eurekaselect.com]
ET-1 is involved also in vascular and cardiac hypertrophy, inflammation, and in the development and progression of cardiovascular diseases - e... [read.qxmd.com]
- Noncompliance
[…] pressure greater than 140/90 mmHg in patients who are treated with 3 antihypertensives, including a diuretic, or controlled hypertension on 4 or more agents.1 Resistant hypertension is distinct from non-controlled hypertension, which includes those noncompliant [education.questdiagnostics.com]
Depending on the series, most apparently resistant hypertension is due to causes such as medication noncompliance, and inadequate drug doses or combinations (4,18). [ncbi.nlm.nih.gov]
Paul Palevsky: One of the major problems in assessing patients with apparent resistant hypertension is medication noncompliance. How do you suggest assessing whether a patient is compliant with his or her medications? Dr. [cjasn.asnjournals.org]
- Swelling
Your body will retain more water and salt than it should, which can result in weight gain and ankle swelling. [mainlinehealth.org]
Gastrointestinal
- Nausea
Have your blood pressure and blood glucose levels tested regularly and see a kidney specialist if you experience fluid retention in your legs, ankles, feet or face; have unexplained fatigue, headache, nausea or vomiting. [mainlinehealth.org]
Symptoms of a hypertensive crisis may include severe chest pain and headache, blurred vision, nausea, anxiety and shortness of breath. The affected person might also be unresponsive or have seizures. [idorsia.com]
- Diarrhea
[…] constipation; hoarseness; weight gain Delayed ankle reflex; periorbital puffiness; coarse skin; cold skin; slow movement; goiter High TSH; low or normal fT4 Hyperthyroidism Warm, moist skin; heat intolerance; nervousness; tremulousness; insomnia; weight loss; diarrhea [ahajournals.org]
Cardiovascular
- Vascular Disease
It is unknown if this condition is related to increased cardiovascular risk in patients with clinically manifest vascular disease. [ncbi.nlm.nih.gov]
Renal Vascular Disease Renal vascular disease is the name given to a variety of complications that affect the arteries and veins of the kidneys. [massgeneral.org]
- Tachycardia
However, headaches, sweating, and tachycardia are common symptoms for disorders like hypoglycemia, migraines, menopause, and so on. [cjasn.asnjournals.org]
[…] was established between the sympathetic nervous system and the development of resistant hypertension, surgical sympathectomy was introduced in the 1930s, but was abandoned shortly afterwards due to multiple side effects such as postural hypotension, tachycardia [revportcardiol.org]
The complications of amphetamines are comparable to those of cocaine and include hypertension and tachycardia.240 Methylphenidate has been implicated in the development of hypertension in children treated for attention deficit disorder.241 Mescaline has [ahajournals.org]
Neurologic
- Headache
We report the case of a 34-year-old male patient who presented with generalized weakness, poorly controlled hypertension, nocturnal hypertension spikes, and morning headaches. [ncbi.nlm.nih.gov]
Symptoms include numbness in the arms and legs, blurred vision, confusion, chest pain, and headache. Resistant hypertension. [everydayhealth.com]
Such actions may include: Skipping your medication : When you take an aspirin and your headache goes away, you know the aspirin is working. [hopkinsmedicine.org]
Workup
Diagnostic workup and management of resistant hypertension were discussed in different clinical presentations. [ncbi.nlm.nih.gov]
At baseline, clinical data were collected and patients underwent echocardiographic measurements, routine blood testing and additional workup for exclusion of secondary causes of RHT (office-based uncontrolled hypertension under at least 3 drugs including [onlinejacc.org]
In addition, this paper will attempt to provide a rational for the workup and treatment of patients with resistant hypertension. 2. [hindawi.com]
Treatment
INTRODUCTION: The effectiveness of renal sympathetic denervation (RDN) as a treatment for therapy-resistant hypertension has been doubted as the Simplicity-HTN-3 trial was unable to show any treatment benefit over sham procedure. [ncbi.nlm.nih.gov]
A total of 106 patients with resistant hypertension were randomly assigned to either RDN with medical treatment (treatment arm, n=52) or medical treatment alone (control arm, n=54). [revportcardiol.org]
Prognosis
CONCLUSIONS: ATRH entails a worse renal prognosis in T2D with hypertension. BP control is not associated with a more-favorable renal outcome in aTRH. [ncbi.nlm.nih.gov]
This article will describe how resistant hypertension is defined, its prevalence and prognosis, methods to diagnose it effectively in routine practice and strategies to effectively manage patients diagnosed with the condition. [heart.bmj.com]
Conclusions In treated hypertensive patients, among prospective RHT dynamic patterns, persistent RHT is frequent and independently associated with adverse cardiovascular prognosis. [onlinejacc.org]
Etiology
The etiology of resistance hypertension is multifactorial. [ncbi.nlm.nih.gov]
In the etiological study of hypertension, several analytical alterations were identified, and they are explained in table 1. [scielo.org.co]
Epidemiology
KEYWORDS: Epidemiology; pharmacology; resistant hypertension [ncbi.nlm.nih.gov]
Definitions of Resistant Hypertension and Epidemiology of Resistant Hypertension Ferro, Charles J. Pages 1-12 Definition and Characteristics of Hypertension Associated with Chronic Kidney Disease: Epidemiological Data Franczyk, Beata (et al.) [springer.com]
Pathophysiology
CONCLUSION: The renin-angiotensin-aldosterone system seems to play a cardinal role in the pathophysiology of resistant HT and requires appropriate management. [ncbi.nlm.nih.gov]
Prevention
Session Title: Prevention: Risk Predictors, Subclinical Atherosclerosis, and Resistent Hypertension Abstract Category: 21. Prevention: Hypertension Presentation Number: 1166M-363C 2014 American College of Cardiology Foundation [onlinejacc.org]
The contribution of carotid baroreceptor feedback in preventing or potentially contributing to the essential hypertensive cascade is poorly understood. [ncbi.nlm.nih.gov]
Clinical Topics: Diabetes and Cardiometabolic Disease, Prevention, Vascular Medicine, Hypertension Keywords: Amiloride, Angiotensin Receptor Antagonists, Antihypertensive Agents, Angiotensin-Converting Enzyme Inhibitors, Arteriovenous Anastomosis, Blood [acc.org]
Update on prevention of cardiovascular disease in adults with type 2 diabetes mellitus in light of recent evidence: A scientific statement from the American Heart Association and the American Diabetes Association. [education.questdiagnostics.com]