What to do when the voltage does not drop

A person with high blood pressure has many medications and lifestyle change options to help lower their blood pressure. Doctors classify resistant hypertension as high blood pressure that does not respond to intensive medical treatment.

Blood pressure is the pressure that blood exerts on the walls of the arteries. High blood pressure occurs when the pressure on the artery walls is greater than it should be. Over time, the extra pressure can damage a person’s artery walls, which can lead to plaque buildup. This plaque buildup can partially or completely block blood flow, which can lead to heart disease or stroke.

The following article discusses resistant hypertension, its symptoms, possible causes, and its treatment.

Resistant hypertension: what is it?

Resistant hypertension occurs when a person’s high blood pressure does not improve when their blood pressure remains above the target and they take three blood pressure medications at the maximum dose, such as:

Long-acting calcium channel blockers
Angiotensin-converting enzyme inhibitors
– angiotensin receptor blockers
– Diuretic
A doctor can diagnose resistant hypertension if a person needs four or more drugs to reach their target blood pressure.

The following blood pressure values ​​indicate elevated or elevated blood pressure:

High: systolic blood pressure is 120 to 129 mm Hg (mm Hg) and diastolic blood pressure is 80 mm Hg.
Stage 1 high blood pressure: systolic blood pressure of 130-139 mm Hg or diastolic blood pressure of 80-89 mm Hg.
Stage 2 high blood pressure: systolic blood pressure above 140 mm Hg or diastolic blood pressure above 90 mm Hg.


Symptoms are not always present. To find out if a person has high blood pressure, they should contact a health care professional for an examination. However, if a person has a hypertensive crisis, they may experience headaches, chest pains, nosebleeds, and shortness of breath. A doctor can diagnose resistant hypertension 6 months after treatment with three blood pressure medications, when a person’s blood pressure remains persistently high.

Causes of resistant hypertension

In most cases, the cause is not clear. Some cases of resistant hypertension occur as a result of secondary hypertension, which is high blood pressure caused by another medical condition. One common cause is primary aldosteronism, a group of disorders in which there is excessive production of aldosterone.
Aldosterone is a hormone that affects the body’s ability to regulate blood pressure. It sends signals to organs that increase the amount of sodium sent into the bloodstream, such as the kidneys.

Other common underlying causes may include:

Sleep problems, such as obstructive sleep apnea
Plaque buildup in the blood vessels that support the kidneys, which can lead to renal artery stenosis
Excessive alcohol consumption
Recreational drug use
– fatter
Abnormalities of hormones that regulate blood pressure, such as hypothyroidism and hyperthyroidism.

If there is no secondary cause, it is likely that the cause is due to various factors.

risk factors

About 10% of people with hypertension have a resistant form. Resistant hypertension shares the same risk factors as high blood pressure, which are:

– fatter
– Diabetes
Lack of activity or exercise
– smoking

treatment or treatment

Treatment for resistant hypertension may vary, depending on the suspected underlying cause. For example, if a doctor discovers that another medical problem is causing high blood pressure, they will treat that problem in addition to trying to lower the blood pressure.

Common treatment options include lifestyle modifications a person can make, including:

– stop smoking
– Reducing alcohol consumption
– Reducing sodium intake
– Eat a healthy diet
physical activity
– To manage stress.
The doctor will also review the medications the person is taking and may suggest different combinations.

How is resistant hypertension diagnosed?

To diagnose resistant hypertension, a doctor must:

A physical examination will be performed
– It will take full antecedents
– Measuring the patient’s blood pressure
Check for secondary conditions.

He can also check if organ damage has occurred due to high blood pressure using the following tests:

Electrocardiogram (ECG)
– chest x-ray
– echocardiogram
– urine anlysis
Endoscopic eye examination to check for damaged blood vessels in the eye.

Complications and outlook

High blood pressure can lead to stroke, heart failure, and heart attack.

Persistent high blood pressure can damage artery walls. Damaged arterial walls are more likely to cause plaque buildup. Once plaque builds up, it can cause partial or complete blockage. If the blockage occurs near the brain, it can cause a stroke. If the blockage is near the heart, it may cause a heart attack.

A 2018 scientific publication notes that people with RH have a higher risk of developing:

Myocardial infarction or heart attack
– Cerebrovascular accident (CVA)
Heart failure
Peripheral arterial disease.

If high blood pressure persists without successful treatment, the risk of heart attack, stroke, and other potential problems increases over time.
A person with resistant hypertension should work with a doctor to control their high blood pressure. Successful management of the condition can help a person reduce their risk of developing other health problems.

Resistant pseudohypertension

Resistant pseudohypertension is high blood pressure that appears to be resistant to treatment. However, pseudohypertension occurs when:

The doctor or person has inaccurate high blood pressure readings
Using the wrong medication, ineffective dosage, or not adhering to treatment.
More accurate blood pressure measurements, medication adjustments, or better adherence to treatment by a person can help improve the condition.

When do you call the doctor?

A person should tell their doctor if their home blood pressure measurements remain elevated despite taking prescribed medications and lifestyle changes. Persistent high levels can indicate that the source is a prerequisite. One should consider getting a home blood pressure monitor. This device can allow him to monitor his blood pressure. Finally, a person should contact their doctor if new or worsening symptoms develop. She should seek emergency medical help if she has symptoms of a heart attack or stroke.

Resistant hypertension occurs when blood pressure remains high despite taking three blood pressure medications from a safe source at their maximum dose, or when a person needs to take four or more to reach the target blood pressure. In a small number of cases, high blood pressure is caused by an underlying condition. The majority of cases have no known cause. After receiving a diagnosis, a person can work with a doctor to adjust their medications and discuss other lifestyle changes that might help.

* Presse Santé strives to impart medical knowledge in a language accessible to all. In no way can the information provided replace medical advice.

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