Why Blood Pressure May Remain High Despite Treatment
Struggling To Control High Bp? Learn About Resistant Hypertension, Its Causes, And Expert-approved Ways To Manage It. Get Insights To Take Charge Of Your Blood Pressure Health.
In a country where resistant hypertension is increasingly being reported among patients, especially those with uncontrolled high blood pressure, it becomes essential to understand its causes and how to manage it effectively.
But what happens if blood pressure remains high despite following all the right measures? This is known as resistant hypertension. Despite being on optimal medication doses and implementing lifestyle changes, this advanced form of hypertension persists.
Dr Anuj Kapadia, Director of Cathlab, Consultant Interventional Cardiologist, Asian Institute of Gastroenterology, Hyderabad, emphasised, “A simple blood pressure check can lead to life-saving interventions. For many, especially those already diagnosed and receiving treatment, the journey doesn’t end with measurement—it marks the beginning.
Secondary causes like renal artery stenosis or hormonal imbalances can be the reason for persistent high readings despite adhering to medications. Early diagnosis can allow for targeted treatments.”
Resistant hypertension is often overlooked or misunderstood
Most people believe high blood pressure despite treatment is due to stress or incorrect doses, but resistant hypertension is a specific medical condition where blood pressure stays high despite being on three or more medications, including a diuretic. Yet, many people are never fully evaluated for it, which can lead to unnecessary changes in medication doses without addressing the real cause, which affects around 10% of hypertension patients. It’s essential to realise that an elevated blood pressure reading is just the start of further investigation.
Skipping medications: A common misunderstanding
Non-adherence to prescribed medication is more common than expected, with studies showing 50-80% of people with hypertension don’t take their medications as prescribed. The reasons can be cost, confusion, or side effects, and they can mimic resistant hypertension. Before the escalation of the treatment, it’s important to check if the medications are being taken, if the medications are being taken regularly, if the doses are adjusted correctly and if patients are receiving proper support and follow-up.
The bigger picture: Factors beyond medication
Resistant hypertension is not only about medication adherence. Sometimes, due to the body’s internal mechanisms, like an overactive sympathetic nervous system or kidney and hormonal issues, blood pressure remains high. Lifestyle choices—excessive salt, alcohol, or weight gain—can worsen the condition, and certain medications can also interfere with the blood pressure.
Emerging solutions beyond medication
Interventional treatments like Renal Denervation are emerging as options when medications fail and secondary causes have been ruled out. This is a minimally invasive procedure that deactivates overactive nerves around the kidneys, offering relief for those whose hypertension remains uncontrolled.
The hypertension crisis in the USA
USA is experiencing a hypertension crisis, with over 220 million adults affected and only 12% having their condition under control. Resistant hypertension often goes unnoticed in this environment. As thorough screening and secondary causes are often overlooked, resistant hypertension often goes unnoticed in this environment. It’s time to act; don’t just measure, take control! Resistant hypertension is more common than we realise in India, and if ignored, it can lead to serious long-term consequences.
Disclaimer: Tips and suggestions mentioned in the article are for general information purposes only and should not be construed as professional medical advice. Always consult your doctor or a dietician before starting any fitness programme or making any changes to your diet.
