Pathophysiology: Metabolic Alterations and Risk Factors

  • Peter M. Nilsson
  • Jan Cederholm


Resistant hypertension is a condition often linked to metabolic abnormalities and increased sympathetic nervous activation. One consequence of this might be insulin resistance and impaired glucose metabolism. As resistant hypertension could be further aggravated through unhealthy lifestyle and neglect of drug intake, it is common to see patients with less healthy lifestyle and worse psychosocial conditions also to have difficult-to-treat hypertension, or in many cases even resistant hypertension. Data from a national diabetes register could show that patients with type 2 diabetes fulfilling criteria of resistant hypertension had a worse risk factor profile as compared to other corresponding patients without resistant hypertension. This calls for screening activities to find and target resistant hypertension, as well as measures to improve lifestyle and psychosocial conditions in order to improve compliance with drug medication and improved pharmacological effect of antihypertensive drugs. If this is not enough, other methods such as renal nerve ablation have to be considered.


Diabetes  Insulin resistance  Lifestyle  Metabolism  Obesity  Resistant hypertension  



We thank all participating patients, regional coordinators, nurses, and physicians who have contributed to the NDR study. The NDR is supported by the Swedish Society for Diabetology and the Swedish Diabetes Federation. The Swedish Board of Health and Welfare funds the NDR.

There were no conflicts of interest.


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Copyright information

© Springer-Verlag Italia 2013

Authors and Affiliations

  1. 1.Department of Clinical SciencesLund UniversityMalmöSweden
  2. 2.Department of Public Health and Caring Sciences/Family Medicine and Preventive MedicineUppsala UniversityUppsalaSweden

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