Appropriate and inappropriate antihypertensive combinations in resistant hypertension. What is good to know
Abstract
Despite advantages in pharmacotherapy, achieving recommended goal of blood pressure is difficult in some patients with arterial hypertension. If the blood pressure persists above 140/90 mm Hg despite administration of at least 3 optimally dosed antihypertensive agents of different classes, one of which is a diuretic, we talk about resistant hypertension, which presents a serious health problem.
Evaluation of possible resistant hypertension begins with an exclusion of pseudoresistance, particularly the assessment of adherence to pharmacotherapy. Also secondary hypertension should be considered.
Combination therapy should be comprehensive and individualized for each patient with regard to age, sex, cardiovascular risk and associated co-morbidities. The absence of a single algorithm generates a number of possible errors in combining of different agents.
This article includes updated knowledge on combination treatment in resistant hypertension with regard to the recently published guidelines for the diagnosis and treatment of hypertension by European Society of Hypertension.