Next-Generation Hypertension Management: Therapies, Devices, and Decision-Making-Current and Future Perspectives in the Management of Uncontrolled and Resistant Hypertension

Current and Future Perspectives in the Management of Uncontrolled and Resistant Hypertension

Video Transcription

Video Summary

The presentation reviews current and emerging approaches to uncontrolled and resistant hypertension. Uncontrolled hypertension remains above target despite two maximally tolerated medications; resistant hypertension persists despite three drugs—including a thiazide-like diuretic—or requires four medications for control. White-coat effects and poor adherence should be excluded.<br /><br />Treatment generally begins with an ACE inhibitor or ARB, a calcium-channel blocker, and a thiazide-like diuretic; spironolactone or another mineralocorticoid-receptor antagonist may be added when appropriate. Emerging options include aldosterone-synthase inhibitors, endothelin-receptor antagonists, and the investigational small-interfering RNA therapy zilebesiran.<br /><br />Renal denervation can reduce blood pressure and medication burden, but it is an invasive adjunct—not a replacement for optimized medical therapy. Decisions should involve a multidisciplinary team and shared discussion of potential benefits and procedural risks. The speaker emphasizes the substantial prevalence of resistant hypertension and the need for further evidence on newer therapies.

Meta Tag

Concept Uncontrolled Hypertension

Concept True Resistant Hypertension

Concept Masked Uncontrolled Hypertension

Concept Pseudoresistant Hypertension

Concept Aldosterone Antagonist

Keywords

resistant hypertension

uncontrolled hypertension

antihypertensive therapy

spironolactone

renal denervation

zilebesiran

Uncontrolled Hypertension

True Resistant Hypertension

Masked Uncontrolled Hypertension

Pseudoresistant Hypertension

Aldosterone Antagonist