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How is Resistant Hypertension Treated?

Resistant hypertension is a condition where blood pressure remains elevated despite the use of three or more antihypertensive medications, including a diuretic. Effective management requires a comprehensive approach:

1. Lifestyle Modifications

Patients should adopt healthy lifestyle changes, including:

  • Balanced diet rich in fruits, vegetables, and low-fat dairy
  • Regular physical activity (at least 150 minutes a week)
  • Weight management to achieve a healthy BMI
  • Limiting sodium intake and avoiding excessive alcohol consumption
  • Quit smoking and manage stress effectively

2. Medication Optimization

Physicians may consider:

  • Adjusting existing medications in terms of dosage and timing
  • Switching to more effective combinations or classes of antihypertensives
  • Using specialized agents such as aldosterone antagonists or centrally acting agents

3. Monitoring and Follow-Up

Regular follow-ups are crucial for:

  • Assessing blood pressure control
  • Identifying medication adherence issues
  • Evaluating for secondary causes of hypertension, like kidney disease

4. Advanced Therapies

In severe cases, advanced treatment options may include:

  • Renal denervation
  • Baroreceptor activation therapy
  • Botulinum toxin injections into the renal arteries

In summary, treating resistant hypertension involves a multifaceted approach targeting lifestyle, medication optimization, and possibly advanced interventions.

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