Treatment of Resistant Hypertension. Which Additional Antihypertensive Drugs?

  • Michel BurnierEmail author
  • Antoinette Pechère Bertschi
  • Gregoire Wuerzner


Inadequate antihypertensive therapy is a frequent cause of resistant hypertension. In addition to a poor adherence to drug therapy, inadequate dosages, inappropriate drug combinations, drug interactions, and intolerance to some medications belong to the most common reasons why blood pressure remains uncontrolled in some hypertensive patients. An important issue in drug therapy of refractory hypertension is the type and dose of diuretics. Adapting the dose of diuretic and combining diuretics may help to improve blood pressure control. Moreover, recent studies have suggested that the addition of aldosterone receptor antagonists is an effective therapeutic to normalize blood pressure in patients with resistant hypertension. Thus, before considering a costly search for secondary hypertension or renal denervation, a careful assessment of drug therapy should be performed.


Resistant hypertension Medical therapy Drug adherence Diuretics Aldosterone antagonists 


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Copyright information

© Springer-Verlag Italia 2013

Authors and Affiliations

  • Michel Burnier
    • 1
    Email author
  • Antoinette Pechère Bertschi
    • 2
  • Gregoire Wuerzner
    • 1
  1. 1.Service of Nephrology and HypertensionUniversity HospitalLausanneSwitzerland
  2. 2.Unit of Hypertension, Departments of Specialties of Medicine and Community Medicine and Primary Care and Emergency MedicineUniversity HospitalGenevaSwitzerland

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