New findings from the Smidt Heart Institute shed light on drug-resistant hypertension and the most effective treatment options.
Researchers at the Smidt Heart Institute reported that roughly one in ten patients with high blood pressure develop a form of hypertension that does not respond to standard drug therapy, and they identified which medication class works best for these patients. The study appeared in the journal Hypertension.
Antihypertensive medications are proven to reduce the risk of heart attack or stroke in people with high blood pressure. Yet a subset of patients experience a resistant form of hypertension. In this work, scientists found that while the condition is not as common as once thought, it remains fairly prevalent among hypertensive individuals.
From a large dataset of electronic medical records, researchers examined about 2.5 million patients, with roughly 55 percent identified as having arterial hypertension. About 8.5 percent, or around 114 thousand people, carried drug-resistant hypertension.
Mineralocorticoid receptor antagonists (MCRs) emerged as the most effective option for lowering blood pressure in those with drug-resistant hypertension. Despite their effectiveness, these drugs were used in only about 11 percent of such patients, primarily due to the challenges in diagnosing this specific form of hypertension.
The investigators emphasized a careful diagnostic approach before labeling a patient as having drug-resistant hypertension. Clinicians should first rule out other potential causes of elevated blood pressure, including stress related to medication adherence, inappropriate medication choices, or the effects of frequent hospital visits. When a patient requires four or more antihypertensive drugs, clinicians should consider evaluating alternative underlying factors that could be driving high blood pressure.
In related progress, some researchers continue to explore how long-term post-viral symptoms may relate to autonomic nervous system function, including the vagus nerve and diaphragm. These lines of inquiry aim to clarify lingering effects and guide future treatment strategies. [Attribution: Hypertension study, Smidt Heart Institute findings; autonomic nervous system and post-viral symptom research.]