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What is refractory hypertension?

What is refractory hypertension?

Refractory hypertension is defined as uncontrolled blood pressure despite use of ≥5 antihypertensive agents of different classes, including a long-acting thiazide-like diuretic and an MR (mineralocorticoid receptor) antagonist, at maximal or maximally tolerated doses.

What do you give for refractory hypertension?

The most common classes of blood pressure medicines are diuretics, calcium channel blockers, and ACE inhibitors/angiotensin receptor blockers (ARBs). Studies have shown that use of the diuretic chlorthalidone is very effective in treating hypertension.

What are the 4 different types of hypertension classification?

Isolated systolic hypertension, malignant hypertension, and resistant hypertension are all recognized hypertension types with specific diagnostic criteria.

  • Isolated systolic hypertension.
  • Malignant hypertension.
  • Resistant hypertension.

What are the causes of resistant hypertension?

Most common secondary causes of resistant hypertension are obstructive sleep apnea, renal artery stenosis, renal parenchymal disease, and primary aldosteronism while some uncommon causes such as pheochromocytoma, Cushing’s disease, thyroid and parathyroid dysfunction; and aortic coarctation also contribute to resistant …

Is refractory hypertension the same as resistant hypertension?

Recently, refractory hypertension has been proposed to refer specifically to antihypertensive treatment failure. As such, it would represent an extreme phenotype of resistant hypertension, referring specifically to elevated blood pressure (BP) that is not controlled in spite of the use of maximal medical therapy.

What is refractory hypotension?

Refractory hypotension is circulatory collapse of obscure cause which occurs in surgical patients who are thought to have a normal blood volume but in whom adequate circulation cannot be maintained.

How is refractory hypotension treated?

Such patients are usually treated empirically by the administration of intravenous vasopressor agents, and the mortality rate is relatively high. A specific diagnosis of the underlying cause for the refractory hypotension can be made by thorough clinical evaluation.

How is resistant hypertension diagnosed?

The diagnosis of resistant hypertension requires use of good blood pressure technique to confirm persistently elevated blood pressure levels. Pseudoresistance, including lack of blood pressure control secondary to poor medication adherence or white coat hypertension, must be excluded.

How do you beat resistant hypertension?

Resistant hypertension is a major cause of stroke and can be overcome. Measures that can markedly improve blood pressure control include sodium restriction in combination with a diet similar to the Cretan Mediterranean diet, and physiologically individualised therapy based on renin/aldosterone phenotyping.

What causes refractory hypotension?

The causes of refractory hypotension have been attributed to decreased cardiac output owing to cardiomyopathy and hypovolemia arising from hypoproteinemia.

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