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Hypertension is a major risk factor for cardiovascular disease. Hypertension is present in 69% of patients with a first myocardial infarction, in 77% of patients with a first stroke, in 74% of patients with congestive heart failure, and in 60% of patients with peripheral arterial disease. Hypertension is also a major risk factor for a dissecting aortic aneurysm, sudden cardiac death, angina pectoris, atrial fibrillation, diabetes mellitus, the metabolic syndrome, chronic kidney disease, thoracic and abdominal aortic aneurysms, left ventricular hypertrophy, vascular dementia, Alzheimer’s disease, and ophthalmologic disorders.
Before a patient is considered to have resistant hypertension, pseudo-resistant hypertension and white coat-resistant hypertension must be excluded. Poor patient compliance, inadequate doses of antihypertensive drugs, inadequate choice of combinations of antihypertensive drugs, poor office blood pressure measurement technique, and having to pay for costs of drugs are factors associated with resistant hypertension.
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