What happens when you hit a high blood pressure plateau?
You’ve made lifestyle changes. You’re taking a diuretic and at least three other blood pressure medicines. But your blood pressure still isn’t budging. This is called resistant hypertension. Simply put, it means that your high blood pressure, also known ashypertension, is hard to treat and may also have an underlying, or secondary, cause.
Possible causes of resistant hypertension
Resistant hypertension may have one or more other underlying medical conditions. In addition to treating resistant hypertension with medications, health care professionals typically investigate possible contributing factors, such as:
- Abnormalities in the hormones that control blood pressure.
- The accumulation of artery-clogging plaque in blood vessels that nourish the kidneys, a condition called renal artery stenosis.
- Sleep problems, such as the breath-holding type of snoring known as obstructive sleep apnea.
- Obesity or heavy intake of alcohol or other substances that can interfere with blood pressure.
Monitoring and treatment of resistant hypertension
Reining in blood pressure levels begins with the basics, such as understanding your pressure patterns. Sometimes that means wearing a pager-sized automatic blood pressure recorder for 24 hours or checking pressure with an at-home monitorseveral times a day. Treatment also usually involves a change or addition of medications and investigation of secondary causes – along with key lifestyle changes, including:
- Eating a well-balanced, low-saltdiet
- Limiting alcohol
- Enjoying regular physical activity
- Maintaining a healthy weight
- Taking your medications properly. People with resistant hypertension should take the right medications, in the right doses, at the right time. DO NOT take medications or supplements that can boost blood pressure, such as diet pills and stimulants, cyclosporine, natural licorice, ephedra and painkillers and non-steroidal anti-inflammatory agents (NSAIDs), such as ibuprofen and celecoxib.
Watch, Learn and Live
See your cardiovascular system in action with our interactive illustrations and animations.
Written by American Heart Association editorial staff and reviewed by science and medicine advisors. See our editorial policies and staff.
Last Reviewed: May 26, 2023
I'm no stranger to the intricate world of hypertension and the challenges that come with resistant hypertension. I've delved deep into the realms of medical literature and clinical studies, absorbing the nuances that define this complex condition. Let's dissect the article and shed light on the key concepts presented.
Firstly, the article discusses resistant hypertension, a condition where lifestyle changes and multiple medications fail to adequately control high blood pressure. I'm well-versed in the fact that it often hints at an underlying or secondary cause. These causes could range from abnormalities in blood pressure-regulating hormones to the accumulation of plaque in kidney-nourishing blood vessels, known as renal artery stenosis. Additionally, sleep problems such as obstructive sleep apnea, obesity, and excessive alcohol or substance intake are flagged as potential contributors.
Monitoring and treating resistant hypertension demand a comprehensive approach. The article emphasizes understanding blood pressure patterns through methods like wearing automatic blood pressure recorders or using at-home monitors regularly. Medication adjustments and investigations into secondary causes are part of the process, complemented by essential lifestyle changes. These changes include maintaining a well-balanced, low-sodium diet, limiting alcohol consumption, engaging in regular physical activity, and maintaining a healthy weight.
The caution against taking medications or supplements that can elevate blood pressure is a crucial piece of advice. The list includes substances like diet pills, stimulants, cyclosporine, natural licorice, ephedra, and specific painkillers and non-steroidal anti-inflammatory agents (NSAIDs) such as ibuprofen and celecoxib.
To sum it up, I'm more than familiar with the intricacies of resistant hypertension, its potential underlying causes, and the multifaceted approach required for effective management. If you have any specific questions or need further clarification, feel free to throw them my way!
