Emerging Treatment Options in Patients With Difficult-to-Treat Hypertension - Episode 4
Expert Perspectives on Treatment Strategies for Resistant Hypertension
Explore effective strategies for managing resistant hypertension, including lifestyle changes, medication adjustments, and advanced treatment options.
Summary for Physicians
Treatment Strategies for Resistant Hypertension
Lifestyle Modifications
Lifestyle changes such as weight loss, increased physical activity, sodium reduction, and alcohol moderation are key components in managing resistant hypertension.
Optimization of the 3-Drug Regimen
Maximizing the doses and combinations of a 3-drug regimen—typically a calcium channel blocker, ACE inhibitor or ARB, and a diuretic—can improve control before considering additional therapies.
Third- and Fourth-Line Medications
If blood pressure remains elevated, adding medications like aldosterone antagonists (eg, spironolactone), beta-blockers, or centrally acting agents (eg, clonidine) may be necessary.
Fifth-Line Medications
In severe cases, devices such as renal denervation or the use of medications like hydralazine or minoxidil may be considered for treatment-resistant hypertension.
Prioritizing Treatment Adjustments
Focus should begin with confirming adherence and addressing lifestyle factors. If blood pressure remains high, optimize the current regimen and consider adding fourth- or fifth-line medications, always tailoring treatment to individual patient needs and comorbid conditions.
