Resistant hypertension: resistance to treatment or resistance to taking treatment?

The treatment of hypertension has been a therapeutic success. A generation or more of effective drugs deserves considerable credit for their contribution to the substantial decline in age-related incidence of stroke, ischaemic heart disease and heart failure. And because almost all the drugs are long-since off patent, the cost of success comes cheaply. Indeed, National Institute of Health and Care Excellence (NICE) has branded treatment of hypertension as not only cost effective but cost saving.1 Yet not all patients achieve their blood pressure target and are labelled as ‘resistant hypertension’. A contentious question has been whether resistant hypertension is a pathogenetic subset of hypertension, justifying a search for ‘stratified medicines’; or is it an imaginary condition caused by doctors in white coats and patients who do not take their tablets? On the one hand, there is abundant evidence that primary aldosteronism causes 20–25% of true treatment resistance.
Source: Heart - Category: Cardiology Authors: Tags: Drugs: cardiovascular system, Hypertension, Interventional cardiology, Epidemiology Editorials Source Type: research