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New Guidelines Tackle Treatment of Resistant Hypertension
Date:4/7/2008

Multi-drug regimens, dose timing, adherence to therapy all matter, heart association says

MONDAY, April 7 (HealthDay News) -- Lifestyle factors and medication recommendations are among the topics covered in the guidelines for treating resistant hypertension released Monday by the American Heart Association.

In patients with resistant hypertension, their blood pressure remains above the target level despite taking three medications to lower it. High blood pressure that's under control but requires four or more medications to treat it, is also considered resistant to treatment.

Studies suggest that as many as 30 percent of people with high blood pressure may have resistant hypertension. Older age and obesity are two major risk factors for the condition, which is likely to become more common in the United States as the population ages and becomes heavier, noted the guideline writing committee.

People with resistant hypertension have a high cardiovascular risk and often have multiple health conditions that complicate efforts to manage their blood pressure.

The first step is to determine whether a person actually has resistant hypertension, which isn't the same as uncontrolled hypertension, the committee said. Successful treatment of resistant hypertension requires consideration of lifestyle factors that contribute to the problem, diagnosing and treating secondary causes, and using multiple drug treatments effectively.

Lifestyle factors noted by the committee included weight, salt intake and alcohol consumption. Obesity is associated with more severe blood pressure and losing weight can lower blood pressure and reduce the number of medications needed to control blood pressure. High dietary salt intake is common among patients with resistant hypertension. In patients with general high blood pressure, reducing salt intake can lower blood pressure. Heavy alcohol intake is also associated with resistant
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