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:2/5/2016)... ... 2016 , ... Successful recruitment and retention efforts, new collaborations ... have all marked the last 12 months at Roswell Park Cancer Institute (RPCI). ... oldest cancer center, Candace S. Johnson, PhD, outlined the many accomplishments of her ...
(Date:2/5/2016)... ... 2016 , ... Looking for a last-minute Valentine’s Day gift for the special ... Foot massage, whether administered by a professional masseuse or a loved one, can bring ... of Multiple Specialties in Podiatry (ABMSP) has taken the upcoming Valentine’s Day as ...
(Date:2/5/2016)... CA (PRWEB) , ... February 05, 2016 , ... ... ChildLight Yoga Studio in Dover, NH to direct high-performance kids yoga training. ChildLight Yoga ... Hampshire’s seacoast, just one hour from Boston. , ChildLight Yoga Studio founder Lisa Flynn ...
(Date:2/5/2016)... , ... February 05, 2016 , ... Give To ... users to search for and donate to Give To Cure’s campaign that is crowdfunding ... that lets users make and share payments through a smart device. In 2015 alone, ...
(Date:2/5/2016)... , ... February 05, 2016 , ... Dr. Justin Scott ... their 2nd Annual No Cost Dental Day to individuals in need. The event is ... of this No Cost Dental Day is to provide dental care to community members ...
Breaking Medicine News(10 mins):
(Date:2/4/2016)... -- Montoya Love is recognized by Continental Who,s Who as ... is the Regulatory Systems Operations Manager with Becton ... Manufacturing and selling a broad range of medical ... institutions, clinical laboratories and life science researchers with the ... An ...
(Date:2/4/2016)...  Omnicell, Inc. (NASDAQ: OMCL ), a leading provider ... today announced results for its fiscal year and fourth ... --> GAAP results: Revenue for the fourth ... or 4.1% from the third quarter of 2015, and ... of 2014. Revenue for the year ended December 31, 2015 ...
(Date:2/4/2016)... (NASDAQ:  AMRI) today announced that Anthony J. Maddaluna , ... Global Supply, has been elected to the AMRI Board of ... Company announced that Mr. Gabe Leung , a director ... from the AMRI Board of Directors in order to devote ... William S. Marth , President and CEO. "We ...
Breaking Medicine Technology: