The American Heart Association has new guidelines for treating resistant high blood pressure.
What is resistant high blood pressure (also known as resistant hypertension)? There are two different types. One type of resistant high blood pressure remains above the normal or target level despite using up to three medications. Another type of resistant high blood pressure requires four or more medications to reach a normal or target level.
Studies suggest that as many as thirty percent of people with high blood pressure may have resistant hypertension. Resistant high blood pressure isn’t the same as uncontrolled high blood pressure, mind you.
Risk factors for resistant hypertension include:
- Older age — this is one risk factor you can’t do much about!
- Obesity — often associated with more severe blood pressure problems
- High salt intake
- Heavy alcohol consumption
- Multiple health conditions that can complicate efforts to manage blood pressure (including sleep apnea and some forms of kidney disease)
- Use of medications that can increase blood pressure (including NSAIDs)
According to the American Heart Association, the best treatment for resistant high blood pressure combines dealing with controllable lifestyle factors (like weight, salt intake, and alcohol consumption), getting other health issues under control if possible, and using multiple drug treatments effectively. The American Heart Association also suggests that a change in dose timing may make a difference in resistant high blood pressure. Another important reminder from the American Heart Association? Patients should be following doctor instructions and medication guidelines precisely.
Some patients with resistant hypertension may benefit from medications called mineralocortoid receptor antagonists (MRAs). As many as twenty percent of people with resistant high blood pressure may have a condition called primary aldosteronism, which responds well to the use of MRAs. Using MRAs can be challenging, because they require more frequent blood tests for monitoring.