Introduction: Resistant Hypertension

      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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