Refractory hypertension

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This article has been translated from WikiSkripta; the formatting needs to be checked.

náhled|200px|Nespolupráce pacienta („non-compliance“) Refractory hypertension (synonym Resistant hypertension, RH) is defined as blood pressure exceeding 140/90 mmHg – despite long enough treatment with triple combinations of antihypertensives of different classes, one of which is a diuretic.

*Currently, the definitions of refractory and resistant hypertension are different: resistant hypertension resists combination therapy of three groups of antihypertensives, one of which is a diuretic, while refractory hypertension resists combination of even five different groups of antihypertensives.

Refractory hypertension affects 5–30% of patients with hypertension.^[1]

Risks[edit | edit source]

Patients with refractory hypertension have a higher risk of (compared to compensated hypertension):

myocardial infarction;
stroke;
dissecting aortic aneurysm;
renal failure;
congestive heart failure.

Causes[edit | edit source]

The causes of refractory hypertension include:

secondary hypertension (must be treated causally);
inadequate antihypertensive treatment (inappropriate combination of antihypertensive drugs, inappropriate dosage);
associated diseases;
concomitant use of nonsteroidal antirheumatic drugs;
patient non-cooperation (patient does not respect the recommended doses and / or intervals; refuses to influence an unhealthy lifestyle: smoking, alcohol, salt, physical activity).