The Challenge of Resistant Hypertension

Welcome back to another HCP Live Peer Exchange series. In this episode titled, ‘The Challenge of Resistant Hypertension,’ expert faculty discuss the persistent burden of uncontrolled and resistant hypertension despite significant advances in cardiovascular care. The panel explores common barriers to achieving blood pressure control, including clinical inertia, medication adherence challenges, inaccurate blood pressure assessment, and difficulties implementing guideline-directed treatment strategies in routine practice.

Throughout the discussion, the panelists examine evolving approaches to hypertension management, including the growing use of combination therapies and strategies to improve patient adherence while minimizing treatment burden. They also share practical experiences navigating patient concerns about initiating antihypertensive therapy and discuss how treatment decisions are individualized based on patient characteristics and preferences.

A major focus of the conversation is the recognition of secondary causes of hypertension. The panel of experts reflects on how traditional assumptions regarding the rarity of secondary hypertension may contribute to underdiagnosis and missed opportunities for intervention. They discuss why clinicians may not routinely evaluate for reversible causes of hypertension and consider the potential implications for patient outcomes when secondary drivers are overlooked.

The faculty emphasize the importance of improving hypertension control as a means of reducing cardiovascular risk and highlight the need for greater awareness of conditions that may contribute to treatment-resistant disease. This discussion provides valuable context for understanding the evolving role of hypercortisolism and other secondary causes of hypertension in cardiovascular practice.

In the next episode, ‘Hypercortisolism as a Driver of Hypertension and Cardiovascular Risk’, panelists will continue their discussion on hypercortisolism and highlight how cortisol excess can contribute to hypertension and cardiovascular risk even in the absence of classic Cushing syndrome features. They also explore emerging evidence linking hypercortisolism to adverse cardiometabolic outcomes and the implications for cardiovascular practice.