Resistant Hypertension: Expert Busts 7 Common Myths About This Condition

Resistant hypertension remains a particularly difficult form of high blood pressure to treat, even in otherwise well-managed patients. These are not patients who are neglecting their health-but are often compliant with their treatment plans, consistent with their prescribed medications, follow a restricted low sodium diet and are physically active. And yet, their blood pressure remains high and is difficult to control.

When a patient's blood pressure stays above target despite optimal doses of at least three anti-hypertensive agents, including a diuretic, we classify that as resistant hypertension. It's not just a matter of poor lifestyle choices or missed doses. Resistant hypertension suggests a more entrenched physiological process that requires careful investigation, long-term monitoring, and often, a tailored treatment approach beyond standard pharmaceutical drugs.

This condition requires more than simply increasing medication doses. It demands a thorough re-evaluation of the patient's overall health, medication effectiveness, adherence, and potential comorbidities. In majority of the cases, an interventional and minimally invasive therapy which is unique, and novel may be suited for these patients. Unfortunately, resistant hypertension remains poorly understood outside of the clinical setting. Many patients internalize the problem-assuming they're at fault for not following the treatment plan effectively-while others fall prey to misinformation or delay seeking specialized care. These misconceptions can interfere with timely diagnosis and access to potentially life-changing interventions.

Myths about resistant hypertension debunked

Myth 1: It's just because you're not taking your medication properly

While non-adherence is one factor, many people with resistant hypertension do follow their medication regimen and still see little to no improvement. True resistant hypertension is defined as uncontrolled blood pressure despite the use of three or more medications, one of which is usually a diuretic.

Myth 2: It's all about diet and exercise

Lifestyle plays a major role in blood pressure-but resistant hypertension often persists even when a person follows a healthy routine. It can be linked to underlying conditions like sleep apnea, kidney disease, or hormonal imbalances such as primary aldosteronism.

Myth 3: It only happens to older adults

While age increases risk, resistant hypertension can affect younger people, especially those with secondary causes or a genetic predisposition. Early diagnosis is key, regardless of age.

Myth 4: More medication is the only solution

In some cases, increasing dosage or adding drugs isn't enough. Treatment may require re-evaluating the medication mix, addressing secondary causes, or considering advanced options like renal denervation- a minimally invasive procedure that uses radiofrequency energy to disrupt overactive nerves in the kidneys that contribute to high blood pressure.

Myth 5: It's rare, so I need not worry

Studies suggest up to 10% of people[] with high blood pressure may have resistant hypertension. It's not rare and it's a major risk factor for stroke, heart attack, and kidney failure.

Myth 6: You can feel It when it's high

Like regular hypertension, resistant hypertension often has no apparent symptoms. That's why regular monitoring is critical, especially if you're already on medication and seeing no improvement.

Myth 7: If I just relax more, it'll go away

Stress can affect blood pressure, but resistant hypertension isn't just about being anxious or overworked. It's a medical condition that usually requires you to take control and consider structured treatment and clinical evaluation.

Resistant hypertension is a complex condition that calls for more nuanced investigation, sometimes with advanced testing, specialist input, or procedures like renal denervation. The first step is awareness. By replacing myths with facts, patients and clinicians alike can work together to find the right path forward.

(Dr. B. C. Kalmath, Director and HOD, Cardiac Sciences, KIMS Hospital, Thane)

Disclaimer: The opinions expressed within this article are the personal opinions of the author. NDTV is not responsible for the accuracy, completeness, suitability, or validity of any information on this article. All information is provided on an as-is basis. The information, facts or opinions appearing in the article do not reflect the views of NDTV and NDTV does not assume any responsibility or liability for the same.