Hypertension is the one of the most common chronic disease, and only about 30% of the patients have their high blood pressure controlled to safe levels. When blood pressure remains uncontrolled despite adequate medications, further investigation to look for endocrine causes and sleep apnea is indicated, if found and treated this reduce patient risk of premature cardiovascular disability, renal disease and death.
What is resistant Hypertension ?
A patient is considered to have resistant hypertension a person is taking a diuretic plus two other blood pressure medications, and their blood pressure is still too high.
Who should be evaluated for the hormonal causes of resistant HTN?
- Uncontrolled BP despite diuretic and two other BP medications
- Spells of uncontrolled BP associated with headache, sweating and palpitations
- Patient with sudden rapid weight gain, round face, supraclavicular or dorsal cervical fat pad (Cushinng’sstigmatas)
- High blood pressure and low potassium levels
- Age less than 30 years (non obese and no family history of HTN and no risk factors for HTN)
- Proven age of onset before puberty
- Malignant or accelerated HTN (Systolic pressure ≥180, and diastolic pressure ≥120mmHg)
Certain sleep problems, including sleep apnea, may also contribute to resistant hypertension.