Understanding Resistant Hypertension: Taking Control of Your Health

According to the World Health Organization, approximately 1.28 billion adults between the ages of 30 and 79 have hypertension, or high blood pressure. Most adults who receive this diagnosis and who are under the supervision of a physician can control their high blood pressure with a combination of careful monitoring, lifestyle changes and medications.

Of the 1.28 billion who have hypertension, about 20% have what is known as resistant hypertension, which requires more intensive medical care and monitoring. CopilotIQ’s advanced monitoring technology, personalized one-on-one care, and health-related information can help individuals understand, track, and treat their resistant hypertension.

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What Is Resistant Hypertension?

The medical industry defines resistant hypertension as high blood pressure that is not controlled after aggressive treatment with three different antihypertensive medications (usually including at least one diuretic medication) at well-tolerated doses. Resistant high blood pressure often has no symptoms, even after several months or years, but can cause serious health issues such as heart attack or stroke.

Patients may also be diagnosed with resistant hypertension when reaching their goals (usually 130/80mmHg or lower) requires the use of four or more medications.

What Is Pseudo-Resistant Hypertension?

Pseudo-resistant hypertension is a little different in that blood pressure only appears to be uncontrolled when being treated with medication. Some of the most common causes of pseudo-resistant hypertension include the following:

  • Incorrect medications, or the correct medications at the wrong doses
  • Other medications or supplements that raise blood pressure or interfere with the efficacy of antihypertensive medications
  • Lifestyle factors (usually diet, activity, or both) that counteract antihypertensive medications
  • The “white-coat effect,” which is a real phenomenon in which patients only experience high blood pressure in clinical settings like doctors’ offices and hospitals
  • Arterial stiffening that prevents traditional blood pressure cuffs from obtaining a true reading
  • Poor or inadequate blood pressure measurement techniques

Although pseudo-resistant hypertension may seem less troublesome or unimportant, it is imperative to diagnose and treat it exactly the same as true resistant hypertension because it carries the same health risks.

What Causes Resistant Hypertension?

While the exact causes of resistant hypertension are not fully understood, researchers and medical experts have discovered a few factors that are common among those who are diagnosed. These factors include the following:

  • Physical inactivity and obesity
  • High-sodium diet
  • Heavy alcohol consumption
  • Various medications that have been shown to interfere with antihypertensives or blood pressure control in certain individuals
  • Failure to comply with treatments as directed
  • Secondary hypertension caused by an underlying condition like kidney failure, an overactive adrenal gland, Cushing syndrome, or renal artery stenosis

Scientists and researchers have also identified some factors that may put individuals at higher risk of developing resistant hypertension. Individuals who are assigned male at birth or African-American are most likely to have this form of hypertension, as are those who have diabetes or chronic kidney disease.

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Signs and Symptoms

Like chronic hypertension, resistant hypertension often has no signs or symptoms, which is why it is critical for adults to monitor their blood pressure closely, particularly if they have had high readings in the past. However, once blood pressures reach the point of potential crisis, it can cause a variety of symptoms such as nausea with or without vomiting, confusion, anxiety, dizziness, headaches, nosebleeds, chest pain, visual issues, breathing difficulty, or a buzzing sensation in the ears.

Treatment Options for Resistant Hypertension

Resistant hypertension treatment follows many of the same guidelines as treatment for non-resistant hypertension. It involves a combination of medications and lifestyle changes, some of which may be aggressive.

Lifestyle Changes

Individuals who are diagnosed as resistant are often instructed to limit their sodium intake, limit or eliminate the use of non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and aspirin, and participating in at least 30 minutes of moderate aerobic activity a day for four to five days a week. The exact limits and exclusions will vary from one patient to the next and may need to be adjusted over time.

Medications

According to the Cleveland Clinic, about 40% of resistant hypertension cases occur because patients are not using their medications as instructed. In these cases, simply taking the prescribed medications at the right doses and the right times can resolve resistance. For those who take their medications as prescribed and are still uncontrolled, doctors may add another medication. Some individuals must take four to five different medications each day to control their blood pressure.

Medications like ACE inhibitors and angiotensin receptor blockers, calcium channel blockers, and diuretics are the most common options. Some individuals may need a much higher diuretic dose based on their potassium levels, and others may need to take an aldosterone antagonist or beta-blocker in addition to their other medications.

Remote Blood Pressure Monitoring and Resistant Hypertension

Remote blood pressure monitoring can be a critical step in diagnosing, treating, and managing resistant hypertension. By taking multiple readings throughout the day, medical professionals can better analyze the efficacy of the current treatment methods, adjust medications and dosages, and recommend different lifestyle changes. Remote monitoring can also help doctors predict and even prevent serious health conditions like cardiac events and strokes.

Connected Continuity of Care

Perhaps the largest impact that remote blood pressure monitoring can make for patients diagnosed with resistant hypertension is improved and connected continuity of care. In today’s dynamic healthcare system, patients often have multiple providers and specialists. Remote blood pressure monitoring makes it incredibly easy for patients to ensure that their providers have access to vital information, and in many cases, it can even reduce the risk of developing resistant hypertension due to interactions between medicines or underlying health conditions.

CopilotIQ’s Approach to Managing Resistant Hypertension with Remote Blood Pressure Monitoring

Resistant hypertension is a serious medical condition that may have very few warning signs or symptoms. Remote blood pressure monitoring can offer patients insight into their health, give doctors the data they need for accurate diagnoses, and in some cases, it even saves lives.

CopilotIQ combines advanced technology with personalized, data-driven care that suits your unique needs. From monitoring your blood pressure readings to helping you make critical lifestyle changes, we make it easy to take charge of your health. Learn more about CopilotIQ’s solutions  for managing resistant hypertension for older adults with Medicare.

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