Let’s understand what Resistant Hypertension is

Dr. Chatterjee

One of our patients came to us with very high blood pressure (BP) (165/105mmHg). The ideal blood pressure is considered to be 120/80mmHg. High blood pressure is considered to be 140/90mmHg or higher. Even after administration of drugs and changing them, her BP never went down and remained stubborn at 140/100mmHg. Uncontrolled high blood pressure is a common condition in today’s high-pressure work and living environment. But in extreme conditions, when high blood pressure can’t be controlled despite medication, it is known as “resistant.”

It is a condition where your blood pressure remains high despite the medication you take to control or lower it. In some patients with Resistant Hypertension, it becomes a major health concern with time. It is rather frustrating for several patients to be on multiple medications and yet not see any improvements in their blood pressure levels. According to experts, people who suffer from Resistant Hypertension are at a much higher risk of stroke, kidney diseases and even heart failure than those who have their high blood pressure in control.

Your blood pressure is constantly higher than the target goal of 130/80 mmHg (although individual targets should be in discussion with the treating doctor) even if you take three blood pressure-lowering medication, including one diuretic (water pill).

  • You are consuming at least four or more medication to control high blood pressure
  • In some cases, any underlying medical condition, or secondary cause, can also be a key factor in keeping your high blood pressure resistant to medications.

Symptoms and Causes of Resistant Hypertension

In most patients, hypertension can go unnoticed for years as it rarely causes any symptoms. But one should remember that untreated conditions of high blood pressure can be potentially dangerous to your overall health.

Once you reach a particular age, you and your doctor should monitor your blood pressure levels. These days with the help of good quality BP machines, you can also keep a regular check on your blood pressure even when at home.

When your blood pressure gets suddenly very high, you may experience a hypertensive crisis that can lead to headaches, shortness of breath and dizziness. In such a condition you need immediate doctor assistance.

What are the causes of Resistant Hypertension?

Lifestyle and Diet: Obesity, high intake of salt, high intake of alcohol, and physical inactivity are some of the causes of Resistant Hypertension.

Drug and Medication: Other causes of poor blood pressure control can be the drugs and medications that you might be taking. Intake of painkillers like ibuprofen and naproxen, birth control pills, ginseng or other herbal products can lead to high blood pressure.

The secondary causes of Resistant Hypertension can be:

  • Excessive production of certain hormones from the adrenal glands
  • Narrowing of arteries of the kidneys
  • Sleep apnea
  • Chronic Kidney Disease

Management and Treatment of Resistant Hypertension

To treat Resistant Hypertension, your doctor may ask you to run a few tests related to kidney or detect the presence of excess hormones that may be leading to high blood pressure.

In some cases, medications for Resistant Hypertension don’t work properly because they are not being taken correctly. For the medicine to work, the right amount of dose should be taken regularly at the right time and the correct number of times per day.

Other than these, lifestyle changes are equally important to treat Resistant Hypertension:

  • Avoiding alcohol, taking a low amount of salt in the diet
  • Limiting the use of painkillers and NSAIDs
  • Engaging in physical activity, and doing at least 30 minutes of yoga or aerobics every day
  • Treating sleep apnea with continuous positive airway pressure.

All the above-mentioned ways should be incorporated into daily life to control high blood pressure.

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