Understanding of intractable hypertension, easily secure treatment

Once you have hypertension, patients should first attach importance to self management, self education. Free read some popular science articles for prevention and treatment of hypertension, and physicians cooperate cheek by jowl, lifelong treatment, long-term prevention, combining prevention with control. But for some special patients with hypertension, need more the doctor-patient cooperation.

Resistant hypertension etiology is complex and diversiform, an Israeli study showed that half of patients have two to three causes, 1/3 of the patients had four or more etiology. How to find and solve these problems in the clinical treatment is very important.

In 1, with intractable hypertension

Can occur in a wide range of atherosclerosis and calcification in older people, measurement of brachial artery blood pressure need higher than arterial lumen cuff pressure can block blood flow. Therefore, the measured blood pressure readings are higher than the actual blood pressure. If aggressive antihypertensive efficacy of poorly, careful treatment still have orthostatic hypotension, hypertension should be considered in the may.

In 2, white coat hypertension

In elderly patients seen in patients in the consulting room, the blood pressure is elevated, but patients go home after the self testing blood pressure or the use of 24h ambulatory blood pressure monitoring confirmed normotensive.

In 3, the patient compliance is not good

This is the most common cause, the clinician when intractable hypertension patients should first consider the problem. Some patients on treatment efficacy, drug prices, drug side effects are suspicious, on hypertension and its harm is not enough awareness, especially in patients with difficult problems, such as: loss of libido and impotence, can not adhere to medication.

In 4, still one part belongs to the doctor failed to properly guide the patient medication

Such as insufficient dose, the lack of treatment, drug use is unreasonable, failed to timely adjust the medication, not drugs combined therapy.

5, obesity is often associated with insulin resistance and hyperinsulinemia, antihypertensive therapy is poor

Weight loss on antihypertensive help. Antihypertensive agents can choose ACEI, ARB, CCB. Obesity can choose lipid-soluble drugs, such as metoprolol, ramipril. Accompanied by diabetes, antihypertensive drugs combined with insulin sensitizer, had better.