I received a lot of feedback on my last post about new guidelines for resistant hypertension. And I thank you for that! So this morning I am going to take a few of the simpler questions that came across, tie them together and do a little Dear Hearty Life of sorts.

Is resistant high blood pressure resistant to exercise and diet regimens and can it be genetic?

Resistant hypertension is high blood pressure that does not respond to treatment. It is defined as blood pressure that remains elevated above treatment goals despite administration of a three drug regimen usually including a diuretic. It can not be diagnosed in full until the treatment has failed.

The most common cause of resistant hypertension, and the most difficult to treat is non- compliance of the patient. The term ‘patient noncompliance’ refers to situations where the patient did not adhere to the treatment for whatever reason, and some are out of the control of the patient.

It is important to figure out the underlying reason behind the resistant hypertension. Is it overactive adrenal glands, secondary hypertension? Is it kidney insufficiency or fluid build up? The physician needs to explore all options and situations before finding a regimen hat would be acceptable for the patient.

For the first time, the American Heart Association has set guidelines in the diagnosis and treatment of resistant high blood pressure. Resistant hypertension is if a person’s blood pressure remains above the goal despite taking three medications to lower as well as high blood pressure that is under control using four or more medications to treat it.

It is important to note that there is a huge difference between uncontrolled and resistant blood pressure. Uncontrolled is when the treatment is not effective and there needs to be more lifestyle changes or more adequate adjustments.

There are many underused types of medications and treatments that hypertension specialists would have a leg up on.

Diuretics are often underused in people with resistant hypertension, and some patients may benefit from adding mineralocorticoid receptor antagonists (MRAs) to their treatment regimens, according to the statement. MRAs treat a condition called primary aldosteronism, which is found in about 20 percent of patients with resistant hypertension.

The bottom line is that you as well as your doctor need to keep up on your blood pressure changes, treatment and keep a log of your lifestyle changes. You need to know if your blood pressure is truly controlled or if it is resistant and if so… seek a hypertension specialist. Persons with resistant high blood pressure have more complications and health issues and why not nip it in the bud, right?