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Spotlight -

This Year In Medicine 2025

Opinion|Videos|January 1, 2025

Patient Case No. 1

Author(s)Manesh R. Patel, MD, Payal Kohli, MD, FACC, John M. Flack, MD, MPH, FASH

Key Takeaways

Difficult-to-treat hypertension involves uncontrolled blood pressure despite using three or more antihypertensive medications, including a diuretic.
It is distinct from resistant hypertension, which is more common and may not include a diuretic in treatment.
This condition affects a smaller subset of patients with high blood pressure and requires a comprehensive management approach.
Lifestyle modifications and evaluation for secondary causes are crucial for optimal management of difficult-to-treat hypertension.

SHOW MORE

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.

Episodes in this series

4 experts are featured in this series.

EP. 1 Unmet Needs in HTN: Patient Adherence, Comorbid Conditions, and Prevalence

4 experts are featured in this series.

EP. 2 Current Limitations With Traditional Antihypertensive Drugs

4 experts are featured in this series.

EP. 3 Drug Classes Available to Treat Patients With High Blood Pressure

4 experts are featured in this series.

EP. 4 Difficult-to-Treat Hypertension Treatment Strategies

4 experts are featured in this series.

EP. 5 Current Therapeutic Guidelines for Managing Resistant Hypertension

4 experts are featured in this series.

EP. 6 Endothelin Pathway

4 experts are featured in this series.

EP. 7 PRECISION trial

4 experts are featured in this series.

EP. 8 Hypertension in Pregnancy and Women

4 experts are featured in this series.

EP. 9 Tips for Precise Readings

4 experts are featured in this series.

EP. 10 Patient Case No. 1

4 experts are featured in this series.

EP. 11 Patient Case No. 2

Patient No. 1 has uncontrolled hypertension despite the use of 4 antihypertensive drugs. They have a slightly abnormal estimated glomerular filtration rate suggestive of early kidney involvement. Their creatinine level is elevated, indicating impaired renal function.
How would you approach the cause of uncontrolled blood pressure in this patient?

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