Advances in the Pathogenesis and Treatment of Resistant Hypertension

Int J Mol Sci. 2023 Aug 18;24(16):12911. doi: 10.3390/ijms241612911.

Abstract

Hypertension is a prevalent chronic disease associated with an increased risk of cardiovascular (CV) premature death, and its severe form manifests as resistant hypertension (RH). The accurate prevalence of resistant hypertension is difficult to determine due to the discrepancy in data from various populations, but according to recent publications, it ranges from 6% to 18% in hypertensive patients. However, a comprehensive understanding of the pathogenesis and treatment of RH is essential. This review emphasizes the importance of identifying the causes of treatment resistance in antihypertensive therapy and highlights the utilization of appropriate diagnostic methods. We discussed innovative therapies such as autonomic neuromodulation techniques like renal denervation (RDN) and carotid baroreceptor stimulation, along with invasive interventions such as arteriovenous anastomosis as potential approaches to support patients with inadequate medical treatment and enhance outcomes in RH.

Keywords: antihypertensive drugs; blood pressure measurement; hypertension; renal denervation; resistant hypertension; secondary hypertension.

Publication types

  • Review

MeSH terms

  • Autonomic Nervous System
  • Humans
  • Hypertension* / etiology
  • Hypertension* / therapy
  • Kidney
  • Therapies, Investigational

Grants and funding

This research received no external funding.