Terápiarezisztens hypertonia: Differenciáldiagnózis és kezelés

Translated title of the contribution: Resistant hypertension - differential diagnosis and therapy

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Hypertension is considered resistant to therapy if the target blood pressure is not achieved despite treatment with three different types of antihypertensive drugs, including a diuretic. Causes of therapy resistance may be grouped into three broad categories: Pseudoresistance can be the result of inadequate blood pressure measurement technique, the "white-coat" effect or the patients' noncompliance with pharmacological and nonpharmacological medical advices. Evaluation of the measurement technique - including the size of the cuff used - and blood pressure monitoring at home can help identify the causes of pseudoresistance. Secondary resistance comprises drug interactions and concomitant medical conditions that elevate blood pressure or antagonize antihypertensive therapy. In addition, secondary resistance can result from disorders associated with secondary hypertension, among which appropriate screening for hyperaldosteronism as well as for renoparenchymal and renovascular hypertension need special emphasis. Suboptimal therapy is frequently related to subclinical volume overload and the use of inappropriate type or dosing of diuretics. Furthermore, when choosing the optimal drug combination, care should be taken to inhibit the various systems that regulate blood pressure as much as possible. In addition to combining the most frequently used antihypertensive drugs, the use of aldosterone antagonists, vasodilators, nitrates or drugs affecting the central nervous system might help to optimise treatment.

Original languageHungarian
Pages (from-to)753-759
Number of pages7
JournalLege Artis Medicinae
Volume19
Issue number12
Publication statusPublished - Dec 2009

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Differential Diagnosis
Antihypertensive Agents
Blood Pressure
Hypertension
Diuretics
Central Nervous System Agents
Mineralocorticoid Receptor Antagonists
Renovascular Hypertension
Ambulatory Blood Pressure Monitoring
Hyperaldosteronism
Drug Combinations
Therapeutics
Patient Compliance
Vasodilator Agents
Drug Interactions
Nitrates
Pharmacology

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Terápiarezisztens hypertonia : Differenciáldiagnózis és kezelés. / Tislér, A.

In: Lege Artis Medicinae, Vol. 19, No. 12, 12.2009, p. 753-759.

Research output: Contribution to journalArticle

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