Learn more about resistant hypertension

There are two main types of hypertension. Primary (or essential) hypertension develops over time without a specific, identifiable cause. It’s usually linked to your lifestyle. Then there’s secondary hypertension, which can be blamed on an underlying condition or medication that impacts your blood pressure.

Those are the main types that most people know and understand. However, there is also “resistant hypertension” - the condition where despite taking multiple medications, your blood pressure is still in dangerous territory.

According to Johns Hopkins Medicine: “Hypertension is considered resistant when all of the following are true”:

• Someone is taking three different blood pressure medications at their maximally tolerated doses.
• One of the blood pressure medications is a diuretic (removes fluid and salt from the body).
• Blood pressure remains above your goal (usually 130/80 mmHg, although individual goals should be discussed with your doctor).
• If hypertension requires four or more medications to be controlled, it is also called resistant hypertension.

What does resistant hypertension mean for my health?

Understandably, it’s concerning if your medications don’t seem to be working and your blood pressure is still outside the safe zone. If high blood pressure isn’t kept under control, it can slowly damage your arteries, making them stiff and narrow.

When this happens, your heart has to exert extra effort to pump blood around your body. Naturally, over time, this can lead to serious problems like strokes, heart attacks, heart failure, and other heart diseases. High blood pressure can also harm your kidneys, affect your memory and eyesight, and even cause erectile dysfunction.

Resistant hypertension isn’t something you should ignore. It’s vital to monitor your symptoms and let your doctor know that your medications aren’t having a positive effect.

What to know about resistant hypertension

• You are not alone. Resistant hypertension can affect up to one in five people with high blood pressure.
• This type of hypertension isn’t quite the same as uncontrolled hypertension. Resistant hypertension means you're already taking multiple medications and still have high blood pressure.
• You may be following all the steps, but resistant hypertension can still happen. Genetics, hormones, or other conditions may be at play.
• Your kidneys might be involved. Kidney problems can cause or worsen resistant hypertension, so it’s worth getting them checked.
• Hormonal issues could also contribute to resistant hypertension. Conditions like primary aldosteronism or sleep apnoea can secretly fuel high blood pressure.
• Some medications can make it worse. Painkillers like NSAIDs, decongestants, and even some herbal remedies can raise your blood pressure.
• It’s more common in older adults. As we age, arteries stiffen and other health issues creep in, making blood pressure harder to control.
• Your lifestyle choices matter. Even though medication is necessary, what you eat, how you sleep, and your stress levels still play a big role.

Managing resistant hypertension

1. Invest in a home blood pressure monitor. It’s a handy tool to track your numbers regularly in between doctor visits.
2. Kick salt to the curb! Start small by cutting back on added salt in food, processed snacks, and salty meats.
3. Ask your doctor or pharmacist about medication interaction, especially if you’re taking medication for other chronic conditions.
4. Do your best to get sleep disturbances and hormonal issues under control.
5. Are you exercising regularly? Just 30 minutes of walking a day can significantly help with your overall wellbeing.
6. Smoking is a NO! Always. Stub it out.
7. If you’re overweight, even a small weight loss might ease the symptoms of blood pressure. Focus on safely losing the weight.
8. A consistent schedule will make it easier to ensure you take your medication on time. Set a reminder on your phone.
9. Don’t ignore the symptoms and hope for the best. Please get in touch with your doctor and let them know to adjust your treatment if it’s not working.

Disclaimer

This article is for informational purposes only. Always check with your doctor or medical practitioner about any health concerns, before embarking on any fitness or nutrition programme, or using any medication.