Practicing nephrologists treat many patients who have hypertension; some of these
patients have hypertension that is difficult to control. Difficult-to-control hypertension
is now defined and characterized better by classifying patients into groups that are
said to have resistant hypertension or refractory hypertension. Resistant hypertension is defined as a condition in which blood pressure is increased
(≥140/90 mm Hg) despite the use of 3 antihypertensive agents in optimal doses, one
of which is a diuretic. The definition of refractory hypertension is less well established.
Some authorities include patients who have uncontrolled hypertension despite the use
of 4 agents in optimal doses in the refractory hypertension group. This issue of Seminars in Nephrology is devoted to defining the epidemiology, pathophysiology, determinants, and the treatment
of resistant hypertension.
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Footnotes
☆Financial disclosure and conflict of interest statements: none.
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© 2014 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
