Why Can’t My Blood Pressure Come Down Even Though I’m Taking Blood Pressure Medicine? Understanding Resistant Hypertension and Treatment Methods

An estimated 32% of adults living in private households in England had high blood pressure (hypertension) and 3 in 10 of those (29%) were undiagnosed; this equates to approximately 4.2 million adults with undiagnosed hypertension. About 10% of patients with hypertension have “resistant hypertension”. What exactly is resistant hypertension? How to treat and alleviate it? We take you inside to understand more.

What is Resistant hypertension?

The blood pressure above 130/80mmgh is the first stage of hypertension, and the blood pressure above 140/90mmgh is the second stage of hypertension.

Resistant hypertension refers to patients who have taken three blood pressure-lowering drugs (including one of them being a diuretic), but their blood pressure is still greater than 130/80mmgh. Commonly used hypertension drugs can be divided into the following 4 categories using “ABCD”:

A: Angiotensin receptor blocker (ARB) and angiotensin-converting enzyme inhibitor (ACE-I)

B: Beta-blockers

C: Calcium-channel blockers

D: Diuretics

If the patient needs to take 4 kinds of drugs to control the blood pressure at 140/90mmgh, it can be diagnosed as resistant hypertension.

According to American Heart Association there are 5 types of blood pressure

Is resistant hypertension dangerous?

Once the blood pressure is higher than 140/90mmgh for a long time, the chances of cardiovascular disease (stroke, myocardial infarction and heart failure) and kidney failure will be greatly increased.
The number of deaths caused by high blood pressure is the disease with the highest growth rate. It is clear that high blood pressure, especially resistant high blood pressure, is harmful to life and health.

How to treat resistant hypertension?

In the past, the treatment direction of resistant hypertension was the same as that of general hypertension, focusing on three aspects: life, diet and drug control:

  1. Drug treatment: Make the most effective adjustments to various types of high blood pressure drugs
  2. Adjust your lifestyle: quit smoking, exercise regularly and maintain a normal schedule
  3. Diet control: reduce salt and alcohol intake and maintain an appropriate weight

However, interventional surgeries are now available that can lower blood pressure and reduce medication use.

After receiving renal sympathetic denervation, hypertension is no longer stubborn

Renal sympathetic denervation has been performed clinically for many years. It blocks sympathetic nerves in the renal arteries to reduce sympathetic nerve activity and stabilize blood pressure. It is a minimally invasive and awake operation; the doctor will puncture the femoral artery in the groin of the mouse. , using an electrocautery hall to regulate the sympathetic nerves in the renal artery, the operation time is only 30 to 40 minutes, the wound is small, and the patient can usually be hospitalized for one night for observation and can be discharged the next day.

Renal sympathetic denervation can reduce blood pressure by 10 to 20 mmgh on average; in other words, if the blood pressure is originally higher than 140 mmgh, it can be reduced to 130 mmgh or even 120 mmgh, and only 2 to 3 types of antihypertensive drugs are needed to restore the blood pressure. There are many treatments for vascular disease and stroke risk, and it is a treatment option that patients with resistant hypertension can fully consider.

Leave a Reply

Your email address will not be published. Required fields are marked *