- Resistant hypertension concerns patients whose blood pressure remains above the blood pressure targets while the patient is receiving antihypertensive treatment.
- The doctor must make sure that the patient takes his treatment and respects the hygieno-dietetic measures.
- More technical causes may be at the origin, such as ancillary treatments, for example anti-inflammatory drugs, or others requiring examinations.
Arterial hypertension (hypertension) is the first risk factor for mortality. It is therefore essential to monitor this silent disease which can lead to serious complications. In some hypertensive patients, a form of resistance to treatment appears which can be the source of a poor cardiovascular prognosis. Professor Jacques Amar, coordinator of the arterial hypertension service at the Toulouse University Hospital, insists on the need for these patients to establish a dialogue with their doctor which, in a majority of cases, makes it possible to identify the causes of this resistance.
High blood pressure despite treatment
Resistant arterial hypertension is defined by Jacques Amar as “hypertension where blood pressure remains above blood pressure targets while the patient is receiving antihypertensive therapy, typically three drugs including a diuretic. ” Concretely, this means that the blood pressure remains above the recommended objective of 140 and / or 90 mmHg in a sitting position despite the combination of a hypertensive triple therapy and hygieno-dietetic rules.
It is essential to know how to identify what causes this resistance in order to adapt the treatment. “It takes a lot of dialogue which, in the majority of cases, will allow us to pinpoint the causes”, Pleads Jacques Amar.
Take your treatment well
As a first step, it is essential for the doctor to make sure that the patient is taking his treatment. “There may be side effects which lead to taking them irregularly, suggests the professor. Some hypertensive people have memory problems and therefore, in fact, this will compromise the taking of medication. ” It may also happen that some patients associate undesirable effects with treatments without these being linked and therefore the doctor will play a preponderant role in reassuring the patient or changing the drug in order to modify the patient’s perception of the patient. this one.
Respect the hygieno-dietetic measures
The first thing for patients to do is to quit smoking and to pay attention to the amount of alcohol they ingest. Then, Jacques Amar identifies “two pillars. What the patient eats and physical activity. You need less salt, more fruits and vegetables. ” Failure to comply with these measures is an important factor of resistance and, here again, their detection requires a dialogue with the doctor so that the latter can see if the hygiene and dietetic measures are respected.
Causes independent of the patient’s lifestyle
There may be causes that are beyond the control of the patient. This can include taking other drugs that can cause resistance, such as anti-inflammatory drugs. “There are then more technical causes such as hormone dosing or renal evaluation., Jacques Amar list. It is necessary to make an assessment and examinations which make it possible to approach the mechanisms of resistance to adapt the treatment or treat the cause of this resistance..”
Below, the interview with Prof. Jacques Amar on resistant arterial hypertension: