Manesh R. Patel, MD; Payal Kohli, MD, FACC; John M. Flack, MD, MPH, FAHA, FASH, MACP, CHS, and C. Michael Gibson, MS, MD, explore the challenges and evolving management strategies for resistant hypertension, including medication adherence, comorbidities like CKD, traditional and novel drug mechanisms like aprocitentan, and the importance of accurate blood pressure measurement, while emphasizing the critical role of the endothelin pathway and comprehensive treatment approaches.
Panelists discuss how poor medication adherence and comorbidities such as chronic kidney disease (CKD) contribute to uncontrolled hypertension despite the availability of numerous treatment options, highlighting key challenges in achieving effective blood pressure management.
Panelists discuss how traditional antihypertensive medications face challenges including adverse reactions, complex dosing regimens, and variable efficacy across different patient populations, which can limit their therapeutic success.
Panelists discuss how antihypertensive treatment encompasses multiple drug classes with distinct mechanisms of action, alongside lifestyle modifications such as dietary changes and exercise, providing a comprehensive approach to blood pressure management.
Panelists discuss how antihypertensive treatment encompasses multiple drug classes with distinct mechanisms of action, alongside lifestyle modifications such as dietary changes and exercise, providing a comprehensive approach to blood pressure management.
Panelists discuss how resistant hypertension management requires a structured approach combining lifestyle modifications, optimal doses of multiple drug classes, and the identification of underlying causes such as sleep apnea.
Panelists discuss how the endothelin pathway critically regulates blood pressure and vascular health through the interplay between vasodilators and vasoconstrictors such as endothelin-1, representing a key mechanism in hypertension pathophysiology.
Panelists discuss how the PRECISION trial evaluated aprocitentan, a dual endothelin receptor antagonist (ERA), in patients with resistant hypertension taking 3 antihypertensive medications including a diuretic.
A panelist discusses how hypertensive disorders during pregnancy remain a leading cause of maternal mortality worldwide, affecting 5-10% of pregnancies and requiring careful monitoring, early detection, and appropriate medical management to protect both mother and baby.
Panelists discuss how proper blood pressure measurement techniques require careful attention to patient positioning, cuff size selection, and standardized procedures to ensure accurate readings.
Panelists discuss how evaluating uncontrolled hypertension in patients with early kidney dysfunction requires a careful investigation of underlying causes, including medication adherence, lifestyle factors, and potential secondary hypertension.
Panelists discuss how chronic kidney disease (CKD) and uncontrolled hypertension create a damaging cycle, in which hypertension accelerates kidney damage while declining kidney function makes blood pressure harder to control.
