Many people with high blood pressure can keep it under control with medication. But for some, the usual treatments just don’t do the trick.
This kind of high blood pressure is known as apparent resistant hypertension (aRH), and it needs more drugs and medical care.
New research from the Smidt Heart Institute at Cedars-Sinai, published in the peer-reviewed journal Hypertension, found that aRH is not as common as previously thought, but it still affects nearly 1 in 10 people with high blood pressure.
A Surprising Treatment Approach
The research team discovered that people with well-managed aRH were more likely to be taking a medication called a mineralocorticoid receptor antagonist, or MRA.
This drug was used in 34% of patients with controlled aRH, but only 11% of those with uncontrolled aRH.
“Apparent resistant hypertension is more common than many would anticipate,” said Dr. Joseph Ebinger, assistant professor of Cardiology in the Smidt Heart Institute and the study’s corresponding author.
“We also learned that within this high-risk population, there are large differences in how providers treat high blood pressure, exemplifying a need to standardize care.”
Diagnosing and Treating aRH
Diagnosing aRH can be as challenging as treating it.
Medical professionals must first rule out other potential reasons for high blood pressure, such as patients not taking their medication correctly, the wrong choice of medication, or a phenomenon called “white coat hypertension” where blood pressure goes up just because the patient is in a doctor’s office.
Patients with aRH are at a higher risk for heart problems. “Identifying these patients and possible causes for their elevated blood pressure is increasingly important,” said Dr. Ebinger.
Both doctors and patients need to be aware of aRH. If a patient’s blood pressure isn’t controlled with four or more medications, doctors should consider looking for alternative causes of hypertension, or refer the patient to a specialist.
Patients should also ask their doctors for help managing their condition, including how to remember to take their medication and deal with any side effects.
Excellence in Treating Hypertension
The Smidt Heart Institute is well known for its expertise in treating complex heart conditions like aRH.
The Institute recently received the American Heart Association’s Comprehensive Hypertension Center Certification, which recognizes its commitment to using research-based guidelines to care for patients with complex or hard-to-treat hypertension.
“This accreditation, coupled with our clinical and research expertise in hypertensive diseases, serves as a mark of excellence,” said Dr. Christine M. Albert, chair of the Department of Cardiology at the Smidt Heart Institute.
“These efforts signal to patients, healthcare providers, and the community that the Smidt Heart Institute is committed to delivering evidence-based, comprehensive care for hypertension.”
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For more information about high blood pressure, please see recent studies about more efficient ways to treat high blood pressure, and potatoes and high blood pressure: what you need to know.
The study was published in Hypertension. Follow us on Twitter for more articles about this topic.
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