A guide for easy- and difficult-to-treat hypertension

Roland E. Schmieder, Massimo Volpe, Bernard Waeber, Luis M. Ruilope

Research output: Contribution to journalArticlepeer-review

Abstract

Although the blood pressure (BP) of many patients can be controlled using standard combinations, treatment of hypertension frequently represents a clinical challenge to the primary care physician. This article will review best practices for managing patients with easy- and difficult-to-treat hypertension, including preferred antihypertensive combinations, optimizing adherence and persistence, recognizing white-coat hypertension, and intensifying therapy for treatment-resistant patients. Each physician must decide based on his or her own level of experience at what point a patient becomes too challenging and would benefit from referral to a hypertension specialist for more intensive management and to complete the exclusion of secondary forms of arterial hypertension. With intensive pharmacotherapy, many patients with difficult-to-treat hypertension can achieve BP control. If it fails, interventional strategies (e.g., renal denervation) are a valid option to get BP controlled.

Original languageEnglish
Pages (from-to)17-22
Number of pages6
JournalInternational Journal of Cardiology
Volume172
Issue number1
DOIs
Publication statusPublished - Mar 1 2014

Keywords

  • Hypertension
  • Renal denervation
  • Treatment algorithm

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Medicine(all)

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