Decreasing the Effects of Aldosterone in Resistant Hypertension — A Success Story

Despite the availability of several medications to treat hypertension, approximately 20% of patients with this condition have apparent resistant hypertension, which is defined as in-office systolic and diastolic blood pressure that is not decreased to less than 130/80 mmHg despite lifestyle measures and treatment with the maximum tolerated doses of three or more drugs, including a diuretic, a renin–angiotensin system blocker, and a calcium-channel blocker.1 Resistant hypertension is associated with an increased risk of premature cardiovascular events.1 The initial workup should rule out pseudo–resistant hypertension with the use of out-of-office blood-pressure measurements, nonadherence to antihypertensive medications, and secondary hypertension.1 Resistant . . .