What Is Treatment-Resistant Hypertension?

Treatment-resistant hypertension is blood pressure (BP) that remains above goal despite compliance with full doses of ≥3 antihypertensive medications of different classes; ideally, 1 of the 3 agents should be a diuretic1,2 and the treatment plan must include attention to lifestyle measures.1 Treatment-resistant hypertension could also include patients who achieve BP control but need ≥4 antihypertensive agents to do so.2

Prevalence and Consequences

The exact prevalence of treatment-resistant hypertension is unknown.2 Small studies estimate it at approximately 5% in general practice and 50% or higher in nephrology clinics, depending on the severity of the underlying chronic renal disease.3 In the NHANES study, the estimated prevalence of treatment-resistant hypertension was 8.9% of all hypertensive adults and 12.8% of all drug-treated hypertensive adults in the US.4 Patients with treatment-resistant hypertension have been shown to have an approximately 3-fold increase in risk for cardiovascular (CV) events versus patients with controlled hypertension.5 No longitudinal study has specially evaluated the prognosis of resistant hypertension.5 The degree to which CV risk is reduced with treatment is unknown, but the benefits of successful treatment are likely substantial.1

A Novel Therapy for Treatment-Resistant Hypertension

Medtronic offers a novel and innovative therapy for treatment-resistant hypertension. The SymplicityTM renal denervation system is a new, safe, and effective tool for healthcare professionals to use for patients who, until this point, have been unable to achieve target blood pressure levels despite multiple prescription medications, and are considered treatment-resistant.6,7 The Symplicity renal denervation system has been successfully used since 2007 to treat more than 4,000 patients with treatment-resistant hypertension worldwide. It was launched commercially in April 2010 and is currently available in parts of Europe, Asia, Africa, Australia and the Americas. Find out more about the Symplicity renal denervation system.

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  1. Mancia G, De Backer G, Dominiczak A, et al. Eur Heart J. 2007;28:14622-15362.
  2. Calhoun DA, Jones D, Textor S, et al. Circulation. 2008;117(25):e510-e526.
  3. Kaplan NM. J Hypertens. 2005; 23:1441-1444.
  4. Persell SD. Hypertension. 2011;57:1076-1080.
  5. Doumas M, Papademetriou V, Douma S, et al. Int J Hypertens. 2011;doi:10.4061/2011/318549.
  6. Symplicity HTN-1 Investigators; Krum H, Barman N, Schlaich M, et al. Hypertension. 2011;57:911-917.
  7. Symplicity HTN-2 Investigators; Esler MD, Krum H, Sobotka PA, et al. Lancet. 2010;376:1903-1909.
  8. Expanded results from Symplicity HTN-1 presented at the American College of Cardiology Annual Meeting 2012.

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