ReviewJournal of clinical hypertension (Greenwich, Conn.)2011
Drug therapy for resistant hypertension: simplifying the approach.
Review in Journal of clinical hypertension (Greenwich, Conn.), 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
16 citing papers in PubMed, 46 citations in OpenAlex.
- Efficacy and Safety of Fimasartan/Indapamide Combination Therapy versus Fimasartan Monotherapy in Patients with Essential Hypertension Inadequately Responding to Fimasartan 30 mg (FINEDUO): A Randomized, Double-Blind, Multicenter, Phase III Study.Drug design, development and therapy · 2026Trial
- Additivity of nebivolol/valsartan single-pill combinations versus other single-pill combinations for hypertension.Journal of clinical hypertension (Greenwich, Conn.) · 2018Trial
- Ginsenoside RbChinese herbal medicines · 2024Review
- Review
- Article
- The efficacy of cognitive behavioral therapy-based interventions on patients with hypertension: A systematic review and meta-analysis.Preventive medicine reports · 2021Review
- Potential Strategies to Reduce Blood Pressure in Treatment-Resistant Hypertension Using Food and Drug Administration-Approved Nanodrug Delivery Platforms.Hypertension (Dallas, Tex. : 1979) · 2019Review
- Blood pressure response to metoprolol and chlorthalidone in European and African Americans with hypertension.Journal of clinical hypertension (Greenwich, Conn.) · 2017Article
- Minoxidil for Treatment of Resistant Hypertension in Chronic Kidney Disease--A Retrospective Cohort Analysis.Journal of clinical hypertension (Greenwich, Conn.) · 2016Article
- Clinical Diagnosis and Management of Resistant Hypertension.European cardiology · 2016Review
- American Society of Hypertension Scientific Statements Addressing Resistant Hypertension.Journal of clinical hypertension (Greenwich, Conn.) · 2016Article
- Treatment resistant hypertension--investigation and conservative management.Deutsches Arzteblatt international · 2014Review
- Exploring issues in difficult-to-treat hypertension.Journal of clinical hypertension (Greenwich, Conn.) · 2013Review
- Psychosomatic research in hypertension: the lack of impact of decades of research and new directions to consider.Journal of clinical hypertension (Greenwich, Conn.) · 2012Article
- A simplified mechanistic algorithm for treating resistant hypertension: efficacy in a retrospective study.Journal of clinical hypertension (Greenwich, Conn.) · 2012Article
- Resistant hypertension: concepts and approach to management.Current hypertension reports · 2011Review
Corrections and comments
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Authors and funding
1 author at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Despite the availability of many effective antihypertensive drugs, the drug therapy for resistant hypertension remains a prominent problem. Reviews offer only the general recommendations of increasing dosage and adding drugs, offering clinicians little guidance with respect to the specifics of selecting medications and dosages. A simplified decision tree for drug selection that would be effective in most cases is needed. This review proposes such an approach. The approach is mechanism-based, targeting treatment at three hypertensive mechanisms: (1) sodium/volume, (2) the renin-angiotensin system (RAS), and (3) the sympathetic nervous system (SNS). It assumes baseline treatment with a 2-drug combination directed at sodium/volume and the RAS and recommends proceeding with one or both of just two treatment options: (1) strengthening the diuretic regimen, possibly with the addition of spironolactone, and/or (2) adding agents directed at the SNS, usually a β-blocker or combination of an α- and a β-blocker. The review calls for greater research and clinical attention directed to: (1) assessment of clinical clues that can help direct treatment toward either sodium/volume or the SNS, (2) increased recognition of the role of neurogenic (SNS-mediated) hypertension in resistant hypertension, (3) increased recognition of the effective but underutilized combination of α- + β-blockade, and (4) drug pharmacokinetics and dosing.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.