Ambulatory Blood Pressure and Adherence Monitoring: Diagnosing Pseudoresistant Hypertension.

Détails

ID Serval
serval:BIB_1E0D6D5B09C9
Type
Article: article d'un périodique ou d'un magazine.
Sous-type
Synthèse (review): revue aussi complète que possible des connaissances sur un sujet, rédigée à partir de l'analyse exhaustive des travaux publiés.
Collection
Publications
Titre
Ambulatory Blood Pressure and Adherence Monitoring: Diagnosing Pseudoresistant Hypertension.
Périodique
Seminars in Nephrology
Auteur(s)
Burnier M., Wuerzner G.
ISSN
1558-4488 (Electronic)
ISSN-L
0270-9295
Statut éditorial
Publié
Date de publication
2014
Peer-reviewed
Oui
Volume
34
Numéro
5
Pages
498-505
Langue
anglais
Notes
Document Type: Review
Résumé
A small proportion of the treated hypertensive population consistently has a blood pressure greater than 140/90 mm Hg despite a triple therapy including a diuretic, a calcium channel blocker, and a blocker of the renin-angiotensin system. According to guidelines, these patients have so-called resistant hypertension. The prevalence of this clinical condition is higher in tertiary than primary care centers and often is associated with chronic kidney disease, diabetes, obesity, and sleep apnea syndrome. Exclusion of pseudoresistant hypertension using ambulatory or home blood pressure monitoring is a crucial step in the investigation of patients with resistant hypertension. Thus, among the multiple factors to consider when investigating patients with resistant hypertension, ambulatory blood pressure monitoring should be performed very early. Among other factors to consider, physicians should investigate patient adherence to therapy, assess the adequacy of treatment, exclude interfering factors, and, finally, look for secondary forms of hypertension. Poor adherence to therapy accounts for 30% to 50% of cases of resistance to therapy depending on the methodology used to diagnose adherence problems. This review discusses the clinical factors implicated in the pathogenesis of resistant hypertension with a particular emphasis on pseudoresistance, drug adherence, and the use of ambulatory blood pressure monitoring for the diagnosis and management of resistant hypertension.
Pubmed
Web of science
Création de la notice
02/01/2015 10:38
Dernière modification de la notice
03/03/2018 14:35
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