Resistant hypertension: consensus document from the Korean society of hypertension

Sungha Park, Jinho Shin, Sang Hyun Ihm, Kwang il Kim, Hack Lyoung Kim, Hyeon Chang Kim, Eun Mi Lee, Jang Hoon Lee, Shin Young Ahn, Eun Joo Cho, Ju Han Kim, Hee Taik Kang, Hae Young Lee, Sunki Lee, Woohyeun Kim, Jong Moo Park

Research output: Contribution to journalReview articlepeer-review

6 Scopus citations

Abstract

Although reports vary, the prevalence of true resistant hypertension and apparent treatment-resistant hypertension (aTRH) has been reported to be 10.3% and 14.7%, respectively. As there is a rapid increase in the prevalence of obesity, chronic kidney disease, and diabetes mellitus, factors that are associated with resistant hypertension, the prevalence of resistant hypertension is expected to rise as well. Frequently, patients with aTRH have pseudoresistant hypertension [aTRH due to white-coat uncontrolled hypertension (WUCH), drug underdosing, poor adherence, and inaccurate office blood pressure (BP) measurements]. As the prevalence of WUCH is high among patients with aTRH, the use of out-of-office BP measurements, both ambulatory blood pressure monitoring (ABPM) and home blood pressure monitoring (HBPM), is essential to exclude WUCH. Non-adherence is especially problematic, and methods to assess adherence remain limited and often not clinically feasible. Therefore, the use of HBPM and higher utilization of single-pill fixed-dose combination treatments should be emphasized to improve drug adherence. In addition, primary aldosteronism and symptomatic obstructive sleep apnea are quite common in patients with hypertension and more so in patients with resistant hypertension. Screening for these diseases is essential, as the treatment of these secondary causes may help control BP in patients who are otherwise difficult to treat. Finally, a proper drug regimen combined with lifestyle modifications is essential to control BP in these patients. Graphical Abstract: [Figure not available: see fulltext.].

Original languageEnglish
Article number30
JournalClinical Hypertension
Volume29
Issue number1
DOIs
StatePublished - Dec 2023

Bibliographical note

Publisher Copyright:
© 2023, The Korean Society of Hypertension.

Keywords

  • Ambulatory blood pressure monitoring
  • Home blood pressure monitoring
  • Hypertension
  • Refractory hypertension
  • Resistant hypertension

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