Resistant Hypertension

Resistant hypertension (RH) is defined as blood pressure above a goal despite adherence to at least 3
optimally dosed antihypertensive medications of different classes, one of which is a diuretic. Evaluation
of possible RH begins with an assessment of adherence to medications. The white-coat effect should be
ruled out by out-of-office blood pressure monitoring. Obesity, heavy alcohol intake, and interfering
substances all contribute to RH. Dietary sodium restriction is an important part of management.

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