Table 1 Definition, characteristics and prevalence of RH.

From: Investigation and management of resistant hypertension: British and Irish Hypertension Society position statement

BIHS RH Definition

• Uncontrolled clinic BP (≥140/90 mmHg) in people with confirmed elevated out-of-office values (average daytime ABPM or HBPM ≥ 135/85 mmHg) AND

• Appropriate lifestyle measures AND

• Use of optimal (or maximum tolerated dose) of at least 3 antihypertensive drugs ideally including an ACE-I/ARB, a CCB and a thiazide-like diuretic AND

• Exclusion of both non-adherence to antihypertensive treatment and secondary causes of hypertension

Characteristics

RH is more common in men, older people, black-African ethnicity, low income, obstructive sleep apnoea, depression, high CVD risk, advanced hypertension-mediated organ damage, high BP at diagnosis, chronic uncontrolled BP, obesity, low physical activity, excessive alcohol and high dietary salt intake.

Prevalence of RH

≈ 5–10% of the hypertensive population

  1. RH resistant hypertension, BP blood pressure, ABPM ambulatory blood pressure monitoring, HBPM home blood pressure monitoring, ACE-I angiotensin converting enzyme inhibitor, ARB angiotensin receptor blocker, CCB calcium channel blocker, CVD cardiovascular disease.
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