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Optimization of Antihypertensive Drug Treatment in Resistant Hypertension

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Interventional Therapies for Secondary and Essential Hypertension

Part of the book series: Updates in Hypertension and Cardiovascular Protection ((UHCP))

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Abstract

When a truly drug-resistant hypertension (dRHTN) has been identified, physicians have to decide which therapeutic option might offer the best chance to effectively lower the elevated blood pressure (BP) values, hopefully leading the patient’s status to BP control (<140/90 mmHg). Although invasive procedures such as renal denervation and carotid baroreflex stimulation can achieve this goal in a number of patients, there is no question that the first treatment approach to consider is the (1) removal of lifestyle factors that may oppose the BP lowering effect of the administered drugs, such as a high intake of salt, abuse of alcohol, obesity or co-treatments that have direct or indirect pressor effects and (2) modification of the existing treatment regimen by an increase of the dose or the extension of the medicaments already prescribed. This chapter will discuss how to make the best use of the medicament option.

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Abbreviations

ACE:

Angiotensin-converting enzyme

BP:

Blood pressure

DBP:

Diastolic blood pressure

dRHTN:

Drug-resistant hypertension

RAS:

Renin-angiotensin system

SBP:

Systolic blood pressure

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Authors and Affiliations

  1. IRCCS Istituto Auxologico Italiano and Policlinico di Monza, University of Milano-Bicocca, Milan, Italy

    Giuseppe Mancia

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  1. Giuseppe Mancia
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Correspondence to Giuseppe Mancia .

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Editors and Affiliations

  1. First Cardiology Clinic, National and Kapodistrian University of Athens, Athens, Greece

    Costas Tsioufis

  2. Department of Nephrology and Hypertension, University Hospital Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany

    Roland E. Schmieder

  3. IRCCS Istituto Auxologico Italiano, University Milano-Bicocca, Milano Monza, Italy

    Giuseppe Mancia

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Mancia, G. (2016). Optimization of Antihypertensive Drug Treatment in Resistant Hypertension. In: Tsioufis, C., Schmieder, R., Mancia, G. (eds) Interventional Therapies for Secondary and Essential Hypertension. Updates in Hypertension and Cardiovascular Protection. Springer, Cham. https://doi.org/10.1007/978-3-319-34141-5_8

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  • DOI: https://doi.org/10.1007/978-3-319-34141-5_8

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  • Publisher Name: Springer, Cham

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  • Online ISBN: 978-3-319-34141-5

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