I’m often referred patients with difficult to control hypertension and here’s my approach, things I think about when assessing these patients. I’m always considering a 24 hour ambulatory blood pressure monitor to exclude white coat effect. I need to make sure to do a careful medication review including over the counter medications.
Pseudoresistant hypertension, hypertension that appears resistant to treatment, but really is controlled. This article will review six things to consider when evaluating apparent resistant hypertension. Resistant Hypertension First, what is resistant hypertension? Resistant hypertension is defined as: Blood pressure above target despite use of three medications of different classes at maximally tolerated
What Is Abiraterone? Abiraterone (Zytiga) is a medication used in the treatment of metastatic prostate cancer. It works by decreasing the production of androgens in the testes, adrenal glands and the prostate tumor (androgen deprivation therapy). Abiraterone inhibits the enzyme Cytochrome P450 C17A1 (CYP17A1). This enzyme has two functions: 17𝝰-hydroxylase 17,20 lyase Inhibition
Thiazide (and thiazide like) diuretics are important medications for the treatment of hypertension (HTN). Thiazide diuretics contain a benzothiadiazine core (hence the name thiazide). Thiazide-like diuretics have the same physiologic effect of blocking the Na+Cl- cotransporter in the distal convoluted tubule, but do not contain the benzothiadiazine core. This article will use the
As a nephrologist I get sent patients with resistant or difficult to control HTN. Here’s an approach, why I do it and what it tells me. 24 hour ambulatory BP monitoring What it tells me: Is it really HTN or is it pseudo resistance? White coat syndrome, white coat effect Technique of measurement.
