Dr. Viveka Kumar – Principal Director & Chief of Cath Labs – Pan Max, Max Super Specialty Hospital, New Delhi
Hypertension affects almost one in three adults in India. While detecting hypertension early is important, understanding what to do next—interpretation, diagnosis, and sustained treatment—is essential. When blood pressure remains elevated despite optimal doses of medication and consistent lifestyle changes, it is known as resistant hypertension.
From Persistent High BP to New Hope: Understanding Resistant Hypertension
As Dr. Viveka stated, “For many patients, especially those already on medication, high readings despite treatment should prompt a thorough investigation. Persistent high BP readings could point to secondary causes such as kidney disorders, hormonal imbalances, or a condition known as resistant hypertension, which requires more specialized treatment. Resistant hypertension doesn’t reflect poor compliance or effort—it often points to more complex underlying factors, such as undiagnosed secondary conditions or inaccuracies in how blood pressure is measured or interpreted.”
The Underdiagnosis of Resistant Hypertension Many believe think that high blood pressure despite treatment is caused by stress or improper medication dosage. Resistant hypertension, however, is a specific condition where blood pressure stays high despite the use of three or more medications, including a diuretic. This condition is often misdiagnosed or misunderstood, leading to unnecessary changes in medication without addressing the root cause.
Non-Adherence: A Common Culprit Many people with hypertension—ranging from 50 to 80%—fail to take their medications as prescribed. This could be due to reasons like cost, side effects, or confusion. Non-adherence is often mistaken for resistant hypertension. It’s important to ensure that patients are following their treatment plans before escalating therapy.
The Role of Internal and External Factors Beyond medication adherence, other factors may also contribute to resistant hypertension. Issues such as an overactive sympathetic nervous system, kidney diseases, hormonal imbalances, and even sleep apnea can contribute to high blood pressure. Furthermore, lifestyle factors like excessive salt intake, alcohol consumption, and weight gain can exacerbate the condition.
Exploring Interventional Options For those whose hypertension remains uncontrolled despite medications, emerging treatments like Renal Denervation (RDN) provide an alternate solution. This minimally invasive procedure deactivates overactive sympathetic nerves around the kidneys, reducing blood pressure for patients who have not responded to conventional treatment.
India’s Hypertension Crisis and Its Implications India faces a massive hypertension epidemic, with over 220 million adults affected, but only 8.5% have their condition under control. Resistant hypertension often goes unnoticed, particularly in rural areas where access to thorough screening and advanced treatments is limited. Recognizing this challenge is essential for effective management.
It’s time to act don’t just measure, take control! Resistant hypertension is more common than we realize in India, and if ignored, it can lead to serious long-term consequences.
Disclaimer: Issued in Public Interest. All information contained herein is for general awareness purposes only and not intended to act as medical advice. Patients should consult with their physicians in relation to their condition
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