Does extracellular volume expansion 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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Answer

Extracellular volume expansion may contribute to the inability to lower systemic BP. The volume expansion may occur because of renal insufficiency or because of sodium retention due to treatment with vasodilators, a high-salt diet, or insufficient dosing of a diuretic. This condition can be treated with more aggressive diuretic therapy until clinical signs of extracellular volume depletion (eg, orthostatic hypotension) develop. The JNC 7 recommends a thiazide-type diuretic for the majority of hypertensive patients but notes that patients with a decreased GFR or who are in heart failure often require therapy with a loop diuretic. [5]


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