Adult Patient with True Resistant Hypertension
Resistant hypertension is defined by the 2013 ESH ESC Hypertension Guidelines as a systolic or a diastolic blood pressure that remains above goal (i.e. >140/90 mmHg for most patients), despite adherence to lifestyle measures and to pharmacological treatment with full doses of at least three antihypertensive medications, including one diuretic. This clinical case describes a patient with true resistant hypertension, a condition in which cardiovascular risk is high. Treatment of true resistant hypertension is a difficult task for the clinician; the therapeutic approach should be based on a well-chosen combination of drugs, tailored on the patient’s characteristics. Few studies are available for the choice of the fourth drug; and available data suggest that mineralocorticoid receptor antagonists or the alpha-1-blocker doxazosin may be effective and well tolerated in this condition.
KeywordsSerum Uric Acid Primary Aldosteronism Resistant Hypertension Target Organ Damage Relative Wall Thickness
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