Navigation Links
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 hypertension. Research shows that reducing alcohol consumption can help lower blood pressure.

The committee also listed a number of health conditions that can contribute to resistant hypertension. They include: obstructive sleep apnea, renal parenchymal disease, primary aldosteronism and renal artery stenosis. Treating these conditions may improve blood pressure control.

Medications were the third area covered by the committee. They said the use of drugs that increase blood pressure, such as non-steroidal anti-inflammatory drugs (NSAIDs), should be reduced or halted, if possible, in patients with resistant hypertension.

The committee noted that diuretics are often underused in people with resistant hypertension. They also said some patients may benefit from adding mineralocorticoid receptor antagonists (MRAs) to their treatment regimens. MRAs treat primary aldosteronism, which is found in about 20 percent of people with resistant hypertension.

"The benefit of mineralocorticoid receptor antagonists in treating resistant hypertension has only been recently confirmed," writing committee chair Dr. David A. Calhoun, a professor of medicine in the Vascular Biology and Hypertension Program at the University of Alabama in Birmingham, said in a prepared statement.

"Hypertension specialists are likely using them to a greater degree, but they are probably not being broadly used to address this problem. Using MRAs requires special biochemical monitoring, particularly to measure blood levels of potassium due to the risk of hyperkalemia [a condition caused by abnormally high potassium levels in the blood]," he said.

Multi-drug regimens, dose timing and patient adherence to medications are also addressed in the guidelines, which were published online in Hypertension.

More information

The U.S. National Heart, Lung, and Blood Institute has more about high blood pressure.



-- Robert Preidt



SOURCE: American Heart Association, news release, April 7, 2008


'/>"/>
Copyright©2008 ScoutNews,LLC.
All rights reserved

Related medicine news :

1. FDA Updates Prescription Guidelines for Blood Thinner
2. New Asthma Guidelines Stress Disease Control
3. Study finds primary care depression treatment often does not follow quality guidelines
4. New lung cancer guidelines oppose general CT screening
5. New Lung Cancer Guidelines Oppose General CT Screening
6. OSHA Issues Draft Ergonomics Guidelines on Preventing Musculoskeletal Injuries in Shipyards
7. Long-awaited international ethical guidelines for biobank researchers
8. Experts Publish New Lung Disease Guidelines
9. Heart Failure Society of America 11th Annual Scientific Meeting to Focus on Heart Failure Guidelines, Innovation and New Research
10. New guidelines set to improve standard of cows milk allergy care
11. GlycoMark Blood Test Included in Global Diabetes Care Guidelines as Emerging Technology
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:3/28/2017)... ... ... Alert Sentry Group LLC., a leader in the Personal Emergency Response System industry, ... iSAFE Plus. These iSAFE products are the most affordable and most advanced medical alert ... offer direct GPS Location and two-way calling with the push of a button on ...
(Date:3/28/2017)... Fairfax, VA (PRWEB) , ... March 28, 2017 , ... ... T. Still, MHA, FRBMA, has begun to serve as its new executive director. Mr. ... and the Executive Search Committee. , “Bob, as he is known to our ...
(Date:3/28/2017)... ... March 28, 2017 , ... Neurotechnology , a provider ... and attendance tracking products: the new NCheck Cloud Bio Attendance cloud-based service and ... biometric face recognition to enable users to check in and out from anywhere ...
(Date:3/28/2017)... , ... March 28, 2017 , ... The Executives, Staff ... raise money to for the Toys for Tots Literacy Campaign at their Semi-Annual Graduation ... excess of $70 billion, the U.S. ranks at number 14 internationally in literacy. Statistically, ...
(Date:3/28/2017)... ... March 28, 2017 , ... Prominant ... Surgical, Inc. is thrilled to offer the recently FDA-approved Obalon Balloon System to ... adds to SkyLex Advanced Surgical’s already comprehensive list of weight-loss services. Dr. ...
Breaking Medicine News(10 mins):
(Date:3/27/2017)... 27, 2017 Therapix Biosciences ... company specializing in the development of cannabinoid-based drugs, today ... the United States of ... 40 ordinary shares of the Company, at a ... has granted the underwriters a 45-day over-allotment option ...
(Date:3/27/2017)... , March 27, 2017 LightIntegra Technology ... appointed William "Bill" Dubiel as President and Chief Executive ... elected to the Board of Directors of LightIntegra. ... Executive Chairman of LightIntegra. "This is ... President and Chief Executive Officer. We,ve selected a very ...
(Date:3/27/2017)... 27, 2017  A new survey from ... Medicare,s Competitive Bidding Program (CBP) significantly reduced beneficiary choice ... lack of choice forces beneficiaries to switch to unfamiliar ... consequences. AADE,s survey is the latest ... others pointing out the inherent problems with the CBP. ...
Breaking Medicine Technology: