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Resistant hypertension: consensus document from the Korean society of hypertension

Authors
 Sungha Park  ;  Jinho Shin  ;  Sang Hyun Ihm  ;  Kwang-Il Kim  ;  Hack-Lyoung Kim  ;  Hyeon Chang Kim  ;  Eun Mi Lee  ;  Jang Hoon Lee  ;  Shin Young Ahn  ;  Eun Joo Cho  ;  Ju Han Kim  ;  Hee-Taik Kang  ;  Hae-Young Lee  ;  Sunki Lee  ;  Woohyeun Kim  ;  Jong-Moo Park 
Citation
 Clinical Hypertension, Vol.29(1) : 30, 2023-11 
Journal Title
Clinical Hypertension
Issue Date
2023-11
Keywords
Ambulatory blood pressure monitoring ; Home blood pressure monitoring ; Hypertension ; Refractory hypertension ; Resistant hypertension
Abstract
Although reports vary, the prevalence of true resistant hypertension and apparent treatment-resistant hypertension (aTRH) has been reported to be 10.3% and 14.7%, respectively. As there is a rapid increase in the prevalence of obesity, chronic kidney disease, and diabetes mellitus, factors that are associated with resistant hypertension, the prevalence of resistant hypertension is expected to rise as well. Frequently, patients with aTRH have pseudoresistant hypertension [aTRH due to white-coat uncontrolled hypertension (WUCH), drug underdosing, poor adherence, and inaccurate office blood pressure (BP) measurements]. As the prevalence of WUCH is high among patients with aTRH, the use of out-of-office BP measurements, both ambulatory blood pressure monitoring (ABPM) and home blood pressure monitoring (HBPM), is essential to exclude WUCH. Non-adherence is especially problematic, and methods to assess adherence remain limited and often not clinically feasible. Therefore, the use of HBPM and higher utilization of single-pill fixed-dose combination treatments should be emphasized to improve drug adherence. In addition, primary aldosteronism and symptomatic obstructive sleep apnea are quite common in patients with hypertension and more so in patients with resistant hypertension. Screening for these diseases is essential, as the treatment of these secondary causes may help control BP in patients who are otherwise difficult to treat. Finally, a proper drug regimen combined with lifestyle modifications is essential to control BP in these patients.
Files in This Item:
T202306305.pdf Download
DOI
10.1186/s40885-023-00255-4
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Family Medicine (가정의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Preventive Medicine (예방의학교실) > 1. Journal Papers
Yonsei Authors
Kang, Hee Taik(강희택) ORCID logo https://orcid.org/0000-0001-8048-6247
Kim, Hyeon Chang(김현창) ORCID logo https://orcid.org/0000-0001-7867-1240
Park, Sung Ha(박성하) ORCID logo https://orcid.org/0000-0001-5362-478X
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/196780
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