AHA updates definition of resistant hypertension, addresses
The American Heart Association has released an updated scientific statement on resistant hypertension that focuses on changes to the definition, approaches to diagnosis and recommendations for treatment of the disease.

Statement Highlight:-
Resistant blood pressure affects 12-15% of people currently being treated for high blood pressure.

This statement is designed to bring recommendations for resistant hypertension in line with the 2017 ACC/AHA clinical practice guideline for adults with hypertension as well as reflect new scientific evidence published during the past decade.

Updated definition:-
• One important update in this scientific statement concerns the definition of resistant hypertension, which has changed in several ways.

• First, the new BP threshold for treatment (130/80 mm Hg) and treatment targets are now consistent with the 2017 ACC/AHA clinical practice guideline. There is also an emphasis on accurate BP measurement through minimizing errors, such as preparation of the patient, environmental conditions, cuff size and technique.

• Second, for patients to be diagnosed with resistant hypertension, they must have BP levels above target while taking at least antihypertensive agents - which are commonly limited to diuretics, long-acting calcium channel blockers and blockers of the renin-angiotensin system such as ACE inhibitors or angiotensin receptor blockers - at maximally tolerated doses, according to the statement.

• Third, to diagnose true resistant hypertension, the white-coat effect must be excluded by not only measuring out-of-office BP using ambulatory or home BP monitoring.

• Fourth, diagnosis of resistant hypertension now requires the exclusion of nonadherence to antihypertensive medications. Nonadherence can be detected through several methods, including “frank and nonjudgmental clinician-patient discussion, monitoring of prescription refills and pill counts, and, if available, biochemical assays of drugs or their metabolites in urine or plasma,” the committee wrote. However, none of these methods are perfect and it may be best to use a combination to assess patient nonadherence.

Read more here: https://pxmd.co/Ysj4X

Scientific statement can be read here: https://www.ahajournals.org/doi/10.1161/HYP.0000000000000084
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