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Chapter-096 Resistant Hypertension: Clinical Evaluation and Management

BOOK TITLE: CSI: Cardiology Update 2014

Author
1. Sharma Sanjeev
2. Ram C Venkata S
3. Wali Mohsin
ISBN
9789351526186
DOI
10.5005/jp/books/12415_97
Edition
1/e
Publishing Year
2015
Pages
7
Author Affiliations
1. Escorts Heart Institute and Research Centre, New Delhi, India, Dr Nagrath’s Nursing Home, Agra, India, Ipswich Hospital NHS Trust, Ipswich, UK, BLK Center for Bone Marrow Transplant, BLK Super Speciality Hospital, New Delhi, India, AIIMS, New Delhi, India, All India Institute of Medical Sciences, New Delhi, India
2. Apollo Institute for Blood Pressure Management, Apollo Blood Pressure Clinics, World Hypertension League/South Asia Office, Apollo Hospitals, Hyderabad, Telangana, India, Texas Blood Pressure Institute, Dallas Nephrology Associates, University of Texas Southwestern Medical Center, Texas, USA, Apollo Institute for Blood Pressure Management/Blood Pressure Clinics; Apollo Medical College, Hyderabad, India; Texas, Blood Pressure Institute; Clinical Research and Medical Education, DNA; University of Texas Southwestern Medical Center; American Society of Hypertension Specialists Program; Dallas, Texas, USA, Apollo Institute for Blood Pressure; Apollo Blood Pressure Clinics, World Hypertension League/South Asia Office, Apollo Hospitals, Hyderabad, Telangana, India, Texas Blood Pressure Institute; University of Texas Southwestern, Medical School; Texas, USA, Apollo Institute for Blood Pressure Management, World Hypertension League/South Asia Office, Apollo Hospitals, Hyderabad, Telangana, India; University of Texas,
3. Ram Manohar Lohia Hospital, New Delhi, India; India, Ram Manohar Lohia Hospital, New Delhi, India
Chapter keywords
Renin-angiotensin-aldosterone system, baroreceptor activation therapy, Renal denervation, calcium channel blockers, continuous positive airway pressure

Abstract

Resistant hypertension is defined as persistent hypertension in spite of lifestyle changes and administration of three different antihypertensive drugs including a diuretic. Also subjects who require more than three antihypertensive drugs to control BP are also described as resistant hypertension. Systemic hypertension is influenced by genetic inheritance and expressed by environmental stimuli. Pathobiology of resistant hypertension is discussed in detail. In patients with confirmed resistant hypertension, secondary cause should be considered on the basis of history, clinical course, physical examination and certain laboratory findings. In patients with resistant hypertension may have an identifiable etiology, the prevalence of secondary causes in this condition is not known. These patients should follow non drug therapy to control BP. Various pharmacological options and principles to treat resistant hypertension are discussed.

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