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Review

Resistant hypertension: A stepwise approach

Jordana Yahr, DO, George Thomas, MD, Juan Calle, MD and Jonathan J. Taliercio, DO
Cleveland Clinic Journal of Medicine February 2023, 90 (2) 115-125; DOI: https://doi.org/10.3949/ccjm.90a.22046
Jordana Yahr
Department of Internal Medicine, Cleveland Clinic, Cleveland, OH
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George Thomas
Director, Center for Blood Pressure Disorders, Department of Kidney Medicine, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH; Associate Professor, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH; Co-principal Investigator for SPRINT and SYMPLICITY HTN-3
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Juan Calle
Department of Kidney Medicine, Glickman Urological and Kidney Institute Cleveland Clinic, Cleveland, OH; Clinical Assistant Professor, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH
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Jonathan J. Taliercio
Program Director, Nephrology and Hypertension Fellowship, Department of Kidney Medicine, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH; Associate Professor, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH; Co-principal Investigator for SYMPLICITY HTN-3
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ABSTRACT

Resistant hypertension can be challenging to manage, but a stepwise approach to diagnosis, evaluation, and treatment can lead to better blood pressure control. In this article, we review the definition and prevalence of resistant hypertension and its diagnostic workup and management, including lifestyle modifications, drugs, and experimental interventional therapies.

  • Copyright © 2023 The Cleveland Clinic Foundation. All Rights Reserved.
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  1. Jordana Yahr, DO
  1. Department of Internal Medicine, Cleveland Clinic, Cleveland, OH
  1. 14722-george-thomasGeorge Thomas, MD
  1. Director, Center for Blood Pressure Disorders, Department of Kidney Medicine, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH; Associate Professor, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH; Co-principal Investigator for SPRINT and SYMPLICITY HTN-3
  1. 17615-juan-calleJuan Calle, MD
  1. Department of Kidney Medicine, Glickman Urological and Kidney Institute Cleveland Clinic, Cleveland, OH; Clinical Assistant Professor, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH
  1. 14008-jonathan-taliercioJonathan J. Taliercio, DO⇑
  1. Program Director, Nephrology and Hypertension Fellowship, Department of Kidney Medicine, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH; Associate Professor, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH; Co-principal Investigator for SYMPLICITY HTN-3
  1. Address:
    Jonathan J. Taliercio, DO, Program Director, Nephrology and Hypertension Fellowship, Department of Kidney Medicine, Glickman Urological and Kidney Institute, Q7, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195; talierj{at}ccf.org

ABSTRACT

Resistant hypertension can be challenging to manage, but a stepwise approach to diagnosis, evaluation, and treatment can lead to better blood pressure control. In this article, we review the definition and prevalence of resistant hypertension and its diagnostic workup and management, including lifestyle modifications, drugs, and experimental interventional therapies.

  • Copyright © 2023 The Cleveland Clinic Foundation. All Rights Reserved.
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Cleveland Clinic Journal of Medicine: 90 (2)
Cleveland Clinic Journal of Medicine
Vol. 90, Issue 2
1 Feb 2023
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Resistant hypertension: A stepwise approach
Jordana Yahr, George Thomas, Juan Calle, Jonathan J. Taliercio
Cleveland Clinic Journal of Medicine Feb 2023, 90 (2) 115-125; DOI: 10.3949/ccjm.90a.22046

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Resistant hypertension: A stepwise approach
Jordana Yahr, George Thomas, Juan Calle, Jonathan J. Taliercio
Cleveland Clinic Journal of Medicine Feb 2023, 90 (2) 115-125; DOI: 10.3949/ccjm.90a.22046
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Jump to section

  • Article
    • ABSTRACT
    • MOVING THE GOALPOST: HYPERTENSION IS NOW 130/80 MM HG OR HIGHER
    • GOAL IS INDIVIDUALIZED, BUT LESS THAN 130/80 FOR MOST
    • RESISTANCE, PSEUDORESISTANCE, OR APPARENT RESISTANCE?
    • PREVALENCE AND PROGNOSIS
    • DIAGNOSIS OF RESISTANT HYPERTENSION
    • DOES THE PATIENT HAVE LIFESTYLE FACTORS THAT RAISE BLOOD PRESSURE?
    • IS THE PATIENT TAKING MEDICATIONS THAT RAISE BLOOD PRESSURE?
    • EVALUATE FOR SECONDARY HYPERTENSION
    • MANAGEMENT OF RESISTANT HYPERTENSION
    • DISCLOSURES
    • REFERENCES
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