دورية أكاديمية
أعرض في EDS

Approaches in Managing Resistant Hypertension: A Review.

التفاصيل البيبلوغرافية
العنوان: Approaches in Managing Resistant Hypertension: A Review.
المؤلفون: Mittal S; Clinical and Preventive Cardiology Department, Medanta Hospital, Gurugram, IND., Jain P; Noninvasive Cardiology Department, Fortis Okhla, Delhi, IND., Sharma R; Heart Rhythm and Pacemaker Division, Fortis Hospital, Mohali, IND., Ponde CK; Cardiology Department, Apollo Hospital, Bhubaneswar, IND., Routray S; Internal Medicine Department, Srirama Chandra Bhanja (SCB) Medical College and Hospital, Cuttack, IND., Chopra S; Internal Medicine Department, Fortis Hospital, Ludhiana, IND., Kumar R; Medical Affairs Department, Dr. Reddy's Laboratories, Hyderabad, IND., Naqvi S; Medical Affairs Department, Dr. Reddy's Laboratories, Hyderabad, IND., Mittal R; Medical Affairs Department, Dr. Reddy's Laboratories, Hyderabad, IND.
المصدر: Cureus [Cureus] 2024 Apr 08; Vol. 16 (4), pp. e57804. Date of Electronic Publication: 2024 Apr 08 (Print Publication: 2024).
نوع المنشور: Journal Article; Review
اللغة: English
بيانات الدورية: Publisher: Cureus, Inc Country of Publication: United States NLM ID: 101596737 Publication Model: eCollection Cited Medium: Print ISSN: 2168-8184 (Print) Linking ISSN: 21688184 NLM ISO Abbreviation: Cureus Subsets: PubMed not MEDLINE
أسماء مطبوعة: Original Publication: Palo Alto, CA : Cureus, Inc.
مستخلص: In India, around 234 million adults (one in three) suffer from hypertension (HTN). An average of 10% of these cases are likely to be resistant hypertension (RH). This load of 23 million patients is expected to expand further with revisions in diagnostic criteria. The treatment and control rates of hypertension in India average around 30% and 15%, respectively. Pharmacological management involves a stepwise approach starting with optimizing the A-C-D (angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs), calcium channel blockers (CCBs), and thiazide-like diuretics) triple-drug combination, followed by substitution with a thiazide-like diuretic and use of spironolactone as a next step (fourth drug). The subsequent steps are suggestions based on expert input and must be individualized. These include using a β-blocker as the fifth drug and an α1-blocker or a peripheral vasodilator as a final option when target blood pressure (BP) values are not achieved. Sodium-glucose cotransporter-2 inhibitors (SGLT2i) are likely to be helpful in managing RH due to their renal and cardiovascular protection as well as mortality benefits. SGLT2i lowers BP independent of the dosage and concomitant anti-hypertensive medications. Patient education and tools to monitor BP and treatment compliance will improve outcomes with these medications. In addition to therapeutic intervention, a preventive approach for RH mandates a need to identify patients at risk and use appropriate preventive and optimal therapy to prevent uncontrolled hypertension in patients with cardiovascular disorders.
Competing Interests: The authors have declared that no competing interests exist.
(Copyright © 2024, Mittal et al.)
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فهرسة مساهمة: Keywords: ace inhibitors and angiotensin receptor blockers; antihypertensive agents; blood pressure; calcium channel blockers; thiazide diuretics; treatment-resistant hypertension
تواريخ الأحداث: Date Created: 20240509 Latest Revision: 20240510
رمز التحديث: 20240510
مُعرف محوري في PubMed: PMC11077320
DOI: 10.7759/cureus.57804
PMID: 38721164
قاعدة البيانات: MEDLINE
الوصف
تدمد:2168-8184
DOI:10.7759/cureus.57804