ReviewHeart international2026
Resistant hypertension: Epidemiology, mechanisms and contemporary therapeutic strategies.
Review in Heart international, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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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0 citing papers in PubMed.
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Authors and funding
9 authors.
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Abstract
Resistant hypertension (RH), defined as uncontrolled blood pressure on three or more antihypertensive agents (including a diuretic) or controlled blood pressure on four or more, poses a major clinical challenge. It disproportionately drives adverse cardiovascular outcomes, including stroke, heart failure and chronic kidney disease. Accurate diagnosis first requires distinguishing true RH from pseudo-resistance, which stems from inaccurate measurement, poor medication adherence and clinical inertia. The pathophysiology is multifactorial, driven by mechanisms such as sympathetic nervous system overactivity, renin-angiotensin-aldosterone system dysregulation, obesity and obstructive sleep apnoea. Consequently, effective management extends beyond mere drug intensification. It demands a comprehensive strategy that addresses lifestyle factors, ensures therapeutic adherence and treats secondary causes. For eligible patients, device-based therapies, such as renal denervation, are emerging as valuable adjuncts to pharmacological treatment. This article synthesizes the current understanding of RH's epidemiology, pathophysiology and diagnostic workup. It also critically examines the evolving landscape of integrated therapeutic strategies, discussing on-going controversies and future research directions to improve patient outcomes.
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