Resistant hypertension—complex mix of secondary causes and comorbidities

Resistant hypertension—complex mix of secondary causes and comorbidities. Por: T. Dudenbostel.  Journal of Human Hypertension (2014) 28, 1–2.

Resistant hypertension (RHTN) is an increasingly common clinical problem1, 2 that studies have suggested is almost always heterogeneous in terms of etiology, risk factors and comorbidities. There has been a growing interest in defining epidemiology and pathophysiology in hope of identifying treatment targets.

Cross-sectional assessments of subjects with RHTN compared with subjects without RHTN have consistently found the former to have an increased frequency of cardiovascular complications, including prior myocardial infarction, stroke, congestive heart failure and chronic kidney disease (CKD). A recent 5-year longitudinal assessment of cardiovascular outcomes in a large cohort of subjects with rigorously defined RHTN demonstrated a 50% increase in cardiovascular events in RHTN subjects compared with patients whose blood pressure (BP) had been controlled on less than or equal to3 medications.