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When patients' BP just won't come down
The Clinical Advisor, 07/16/09

Sherman C - Uncontrolled hypertension remains a taxing clinical problem. Various surveys reveal that <=50% of patients under treatment achieve target BPs (<140/90 mm Hg; 130/80 for those with diabetes or chronic kidney disease). A substantial proportion of patients (exact number uncertain) suffer from "resistant hypertension," i.e., their BP remains elevated despite concurrent use of three agents of different classes. In its first Scientific Statement to focus on this issue, the American Heart Association (AHA) stresses the need for evaluation that spreads a broad net to identify contributing and secondary causes and treatment options that go beyond the usual antihypertensives.

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