Marc Cohen, MD, FACC

A panelist discusses how resistant hypertension is defined as persistently high blood pressure (>135/85 mm Hg) despite patients being on multiple antihypertensive medications and occurs in approximately 1 in 5 compliant patients.

An Overview of Resistant Hypertension and Prevalence 

Resistant hypertension represents a challenging clinical condition affecting patients who continue to experience elevated blood pressure despite taking multiple antihypertensive medications. Dr Marc Cohen defines resistant hypertension as persistent high blood pressure readings above 135/85 mm Hg in patients already receiving comprehensive treatment including multiple drug therapies and lifestyle counseling regarding sodium intake reduction. This condition requires careful evaluation to distinguish between true medication resistance and other contributing factors.

The prevalence of genuine resistant hypertension in clinical practice is significant but often overestimated due to patient adherence issues. When health care providers thoroughly investigate patient compliance with prescribed medications and lifestyle modifications, the true incidence of resistant hypertension narrows considerably. Dr Cohen estimates that approximately one in four to one in five patients who are truly adherent to their treatment regimens still experience uncontrolled blood pressure, highlighting the complexity of this cardiovascular condition.

Healthcare professionals must differentiate between apparent treatment resistance and actual resistant hypertension through comprehensive patient assessment. This distinction is crucial for developing effective treatment strategies and avoiding unnecessary medication escalation. Understanding the true prevalence helps clinicians set appropriate expectations and allocate resources effectively for managing this challenging subset of hypertensive patients who require specialized care approaches and advanced therapeutic interventions.

Marc Cohen, MD, FACC

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