Approach to Resistant Hypertension: The Endocrine Angle

Resistant hypertension, defined as blood pressure uncontrolled despite optimal doses of three antihypertensives including a diuretic, often has an underlying endocrine cause. Common etiologies include primary aldosteronism, pheochromocytoma, Cushing’s syndrome, thyroid and parathyroid disorders. A...

• Resistant hypertension is defined as blood pressure above the target despite adherence to three anti-hypertensive agents of different classes, one of which is ideally a diuretic, or controlled blood pressure requiring four agents or more. It's often misdiagnosed due to pseudo-resistant hypertension (poor measurement technique, white-coat syndrome) and should be distinguished from refractory hypertension, which remains uncontrolled despite five or more agents.