Edit concept Question Editor Create issue ticket

Resistant Hypertension

Hypertension Resistant to Conventional Therapy


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]
Resistant Hypertension
  • To make our point, we first reviewed the prevalence and risks associated with treatment-resistant hypertension.[ncbi.nlm.nih.gov]
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]
  • 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]
  • 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]
  • 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]
Short Stature
  • A radial access was chosen because the patient was very obese and of short stature.[ncbi.nlm.nih.gov]
Loud Snoring
  • Daytime sleepiness, loud snoring, and witnessed apnea are suspicious for sleep apnea. A history of peripheral or coronary atherosclerotic disease increases the likelihood of renal artery stenosis.[circ.ahajournals.org]
  • However, given the high prevalence of often severe OSA in patients with RH and the potential benefit of CPAP to enhance BP control, clinicians should vigorously screen such patients for symptoms of OSA (loud snoring, frequent nocturnal arousals, witnessed[ahajournals.org]
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]
Ejection Murmur
  • Physical exam revealed a systolic ejection murmur, and ECHO demonstrated moderate hypertrophy.[ncbi.nlm.nih.gov]
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]
  • 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]
  • 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]
Morning 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]

Workup

  • The authors report a case and review the diagnostic workup of Conn syndrome in which resistant hypertension and hypokalemia were cured by unilateral adrenalectomy.[ncbi.nlm.nih.gov]
Aldosterone Decreased
  • On administration of pioglitazone (30 mg/d) and nifedipine (40 mg/d), hypertension and hypokalemia improved and plasma aldosterone decreased for more than 6 months.[ncbi.nlm.nih.gov]

Treatment

  • Our conclusion is that optimising medical treatment based on simple algorithms remains the state of the art in treatment-resistant hypertension.[ncbi.nlm.nih.gov]

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]
  • Thus, the use of spironolactone has been associated with better prognosis in patients with heart failure,4 while it has been pointed out that treatment with doxazosin has been related with a higher incidence of heart failure, although it seems that this[revespcardiol.org]
  • Resistant hypertension: incidence, prevalence, and prognosis. Circulation. 2012;125(13):1594–6. View Article PubMed PubMed Central Google Scholar Daugherty SL, et al. Incidence and prognosis of resistant hypertension in hypertensive patients.[pilotfeasibilitystudies.biomedcentral.com]

Etiology

  • Aortic coarctation, a congenital narrowing in the region of the ligamentum arteriosium, is a rare etiology for multi-drug-resistant hypertension in adulthood; however, advances in stenting modalities may offer long-term improvements in morbidity and possibly[ncbi.nlm.nih.gov]
  • SMASH-U: a proposal for etiologic classification of intracerebral hemorrhage. Stroke (2012) 43:2592–7. doi:10.1161/STROKEAHA.112.661603 PubMed Abstract CrossRef Full Text Google Scholar 5.[frontiersin.org]
  • Treatment Recommendations Resistant hypertension is almost always multifactorial in etiology.[circ.ahajournals.org]

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]
Sex distribution
Age distribution

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

  • The contribution of carotid baroreceptor feedback in preventing or potentially contributing to the essential hypertensive cascade is poorly understood.[ncbi.nlm.nih.gov]

Ask Question

5000 Characters left Format the text using: # Heading, **bold**, _italic_. HTML code is not allowed.
By publishing this question you agree to the TOS and Privacy policy.
• Use a precise title for your question.
• Ask a specific question and provide age, sex, symptoms, type and duration of treatment.
• Respect your own and other people's privacy, never post full names or contact information.
• Inappropriate questions will be deleted.
• In urgent cases contact a physician, visit a hospital or call an emergency service!