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Resistant Hypertension

True resistant hypertension is defined as blood pressure that remains above target despite concurrent use of three antihypertensive agents of different classes (including a diuretic) at optimal doses.

1. Rule Out Pseudo-Resistance

Before investigating secondary causes, you must exclude factors that mimic resistant hypertension:

  • White Coat Effect: Confirm elevated BP with 24-hour Ambulatory BP Monitoring (ABPM) or strict home monitoring.
  • Non-adherence: Account for >50% of apparent resistance. Discuss openly without judgment.
  • Suboptimal Dosing: Ensure patients are on maximal tolerated doses, not just starter doses.
  • Inaccurate Measurement: Wrong cuff size, patient talking, arm unsupported, or no rest period before measurement.

2. Screen for Interfering Substances

Common medications and substances that elevate BP:

  • NSAIDs (Ibuprofen, Naproxen, Celecoxib)
  • Oral contraceptives
  • Sympathomimetics (decongestants like pseudoephedrine, diet pills)
  • Excessive alcohol intake (>2 standard drinks/day)
  • Recreational drugs (Cocaine, Amphetamines)
  • Licorice (contains glycyrrhizin)

3. Workup for Secondary Causes

If true resistance is confirmed, investigate secondary causes (accounting for 10-20% of resistant cases):

Cause Clinical Clues Initial Screening
Primary Aldosteronism Hypokalemia (spontaneous or diuretic-induced), muscle weakness Aldosterone/Renin Ratio (ARR)
Obstructive Sleep Apnea Snoring, daytime somnolence, obesity, morning headaches STOP-BANG questionnaire, Polysomnography
Renal Parenchymal Disease Elevated creatinine, abnormal urinalysis, nocturia eGFR, Urinalysis, Renal Ultrasound
Renovascular Disease Abdominal bruit, flash pulmonary edema, acute Cr rise with ACEi/ARB Doppler US, CTA, or MRA of renal arteries

4. Pharmacological Escalation (Step 4 Therapy)

Once adherence is confirmed and secondary causes are ruled out or treated, pharmacological escalation is required.

The PATHWAY-2 Trial established that adding an MRA (Mineralocorticoid Receptor Antagonist) is the most effective 4th-line agent for resistant hypertension.

  1. Step 4: Add Spironolactone (12.5-50 mg/day). Ensure eGFR > 30 and K+ < 4.5 mEq/L before starting. Check U&Es 1-2 weeks after initiation.
  2. Step 5 (If MRA contraindicated/ineffective): Add Beta-blocker (if HR > 70) OR Alpha-blocker (Doxazosin) OR centrally acting agent (Clonidine).
  3. Step 6: Direct vasodilator (Hydralazine or Minoxidil) - Usually requires specialist referral due to reflex tachycardia and severe fluid retention (requires concurrent beta-blocker and potent loop diuretic).