Resistant hypertension

Fang-Fei Wei, Zhen-Yu Zhang, Qi-Fang Huang, Wen-Yi Yang, Jan A. Staessen*

*Corresponding author for this work

    Research output: Contribution to journal(Systematic) Review article peer-review

    3 Citations (Web of Science)

    Abstract

    The publication of the first non-randomised proof-of-concept trial of renal denervation as a treatment modality in treatment-resistant hypertension set the stage for a search for novel devices with the expectation that technology would reduce the burden of hypertension by reducing or eliminating the costly and lifelong use of blood pressure-lowering medications. As we demonstrate in this review, this idea was so attractive to manufacturers and invasive cardiologists and radiologists that they overlooked decades of careful pathophysiological research in a disease that remains enigmatic but is still a major cause of cardiovascular mortality worldwide. To make our point, we first reviewed the prevalence and risks associated with treatment-resistant hypertension. Next, we highlighted the key points required for the diagnosis of treatment-resistant hypertension, including the recording of ambulatory blood pressure and the assessment of adherence to medication. Finally, we summarised new insights in the management of treatment-resistant hypertension by medication and devices as well as in future research. Throughout our review, we focused on new evidence that had become available since 2013. Our conclusion is that optimising medical treatment based on simple algorithms remains the state of the art in treatment-resistant hypertension.
    Original languageEnglish
    Pages (from-to)1031-1042
    Number of pages12
    JournalKardiologia Polska
    Volume76
    Issue number7
    DOIs
    Publication statusPublished - 1 Jan 2018

    Keywords

    • resistant hypertension
    • pharmacology
    • sympathetic nervous system
    • baroreflex
    • renal denervation
    • AMBULATORY BLOOD-PRESSURE
    • BAROREFLEX ACTIVATION THERAPY
    • RENAL SYMPATHETIC DENERVATION
    • RANDOMIZED CONTROLLED-TRIAL
    • WHITE-COAT HYPERTENSION
    • RHEOS PIVOTAL TRIAL
    • PROOF-OF-CONCEPT
    • UNCONTROLLED HYPERTENSION
    • CARDIOVASCULAR RISK
    • EUROPEAN-SOCIETY

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