Do inadequate treatment or patient noncompliance cause resistant hypertension (high blood pressure)?

Updated: Feb 22, 2019
  • Author: Matthew R Alexander, MD, PhD; Chief Editor: Eric H Yang, MD  more...
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Inadequate treatment is common in cases of resistant hypertension [5] ; in several published series, this has been described as the most common cause of resistant hypertension. Patients may not be on an effective drug or drug dose, or concomitant volume expansion may occur as a side effect of the drug.

Noncompliance with medical therapy [42, 117] or dietary modifications (eg, salt restriction) may play a role in causing resistant hypertension. Address noncompliance with extensive patient education, simplification of the drug regimen, use of fixed-dose combinations, and use of drugs with the fewest adverse effects.

Limited data suggest better compliance with angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs) than with some of the other antihypertensive medications. [118]

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