What happens if neither lifestyle changes nor different medications bring down high blood pressure? Dr. Judit Kapocsi PhD, specialist in high blood pressure and vascular risk at KardioKözpont he talked about resistant hypertension.
What could be the reason?
(Drug) resistant hypertension refers to a condition where high blood pressure does not decrease despite lifestyle changes or the maximum tolerable dose of at least 3 medications (one of which is a diuretic). This condition is difficult to treat, but the most important step must be taken: finding out what is causing the phenomenon. First of all, the obvious reasons that the patient really needs to be looked into are you taking your medication as prescribed, is the dose of the prescribed medication appropriate, and that it is not the so-called due to white coat syndrome, the value is high in the presence of a doctor.
According to Dr. Kapocsi, the possibility of overtreatment should also be examined when large amounts of the drug cause a severe drop in blood pressure, in response to which the mechanisms responsible for controlling blood pressure overcompensate, and cause blood pressure spikes. Adding to this can be the patient’s increasingly stressful state, which is caused, among other things, by “failed treatment”.
If these questions have been satisfactorily answered, it is necessary to find out whether it is not secondary hypertension, that is, that the blood pressure has risen as a result of a primary disease.
Possible causes of resistant hypertension include:
– A problem with the functioning of hormones that control blood pressure.
– Renal artery stenosis, which causes less blood to flow through the kidneys, making them feel like their blood pressure is low. Therefore, the hormone called renin is released, and then the activity of the vasoconstrictor and substances that retain water and salt in the kidneys increases, which causes the blood pressure to rise.
– Sleep disorders, fas sleep apnea, which is a type of nocturnal breathing interruption during which the patient does not breathe for a while in his sleep, and then wakes up gasping for air, even several times a night.
“Existing.” cardiovascular disease and/or diabetes.
– Obesity, alcoholism or consuming other substances that raise blood pressure.
What can be done?
First of all, you need to make sure that your blood pressure has always been elevated, but a few measurements at home and in the doctor’s office are not enough. In such cases, 24-hour blood pressure monitoring can be a very useful tool. If it turns out that it really is resistant hypertension, and it may have turned out that there is an underlying disease, which should be treated first. If this is not the case, and true therapy-resistant hypertension is established, treating it with medication is a difficult task. In such cases, we can prescribe an appropriate combination of blood pressure-lowering drugs belonging to at least three functional groups, taking into account the patient’s unique characteristics and goals, he emphasizes dr. Judit Kapocsi PhD, KardioKözpont’s high blood pressure and vascular risk specialist.
In addition to appropriate and indispensable drug treatment, it is of course also worthwhile to introduce changes in lifestyle, optimally with the help of a lifestyle doctor. The most important things are a balanced, low-salt diet, limited alcohol consumption, regular exercise, maintaining a normal body weight and managing stress. If regular cardiological control is added to all of this, there is a good chance that blood pressure can be kept under control.
Source: Cardio Center
Source: www.patikamagazin.hu
