Navigation Links
New Guidelines Tackle Treatment of Resistant Hypertension

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:
(Date:11/30/2015)... ... November 30, 2015 , ... While powdered supplements and drinks can reduce food ... inventor from Chesterfield, Va., has found an easy to keep track of the scoop. ... measure powdered contents in a canister or other container handy and readily accessible. As ...
(Date:11/30/2015)... ... November 30, 2015 , ... Volpara ... breast density assessment and enterprise analytics solutions, here at the 101st Annual ... Hall booth #2377). Volpara’s quantitative breast imaging tools enable personalized measurements of ...
(Date:11/30/2015)... DC (PRWEB) , ... November ... ... Inc. (AIS) is pleased to announce the speakers for “Value-Based Payer-Provider Partnerships: ... lessons learned from three innovative value-based care arrangements: Essentia Health and UCare, ...
(Date:11/30/2015)... , ... November 30, 2015 , ... ... alliance around Novus’ TIGR® Matrix Surgical Mesh technology for soft tissue repair in ... TIGR® Matrix is a long-term resorbable surgical mesh intended to support and reinforce ...
(Date:11/30/2015)... ... November 30, 2015 , ... GKhair & Tibolli team members and artists ... Show held on November 8th and 9th at the Puerto Rico Convention Center, San ... renowned beauticians and top of the line fashion journalists. The San Juan Beauty Show ...
Breaking Medicine News(10 mins):
(Date:11/30/2015)... Months Ended 30 September 2015 2014RestatedChange%Turnover 545,575 , 518,852 , ... 384,242 , 9.8 Hospital Management Service Income ... (18.3) Medical Insurance Administration Service Income , 2,780 ... and Accessories Sales , 89,645 , 94,580 ... 2,822 , 2,917 , (3.3) Gross ...
(Date:11/30/2015)... , Nov. 30, 2015  PTS Diagnostics, the U.S.-based ... ® analyzers, A1CNow ® systems, and PTS ... family of patents that will propel the company into ... and Europe . The technology is ... as those on smartphones and tablets, and uses test ...
(Date:11/30/2015)... -- Cumberland Pharmaceuticals (CPIX), today announced that A.J. Kazimi , ... 3, 2015. TIME: 3:15p.m. ET LINK: ... --> DATE: Thursday, December 3, ... --> --> This will be ... ask the company questions in real-time - both in the ...
Breaking Medicine Technology: