Professor Jacques Amar, coordinator of the arterial hypertension department at the Toulouse University Hospital, insists on the need for dialogue with his doctor in order to detect the causes of resistance to hypertensive treatment, which in the majority of cases makes it possible to pinpoint his origin.
- Resistant hypertension concerns patients whose blood pressure remains above blood pressure targets while the patient is receiving antihypertensive treatment.
- The doctor must make sure that the patient takes his treatment and respects the hygiene and dietary measures.
- More technical causes may be at the origin such as additional treatments, for example anti-inflammatories, or others requiring examinations.
Arterial hypertension (HTA) is the first risk factor for mortality. It is therefore essential to monitor this silent disease which can lead to serious complications. Some hypertensives develop a form of resistance to treatment which can be a source of poor cardiovascular prognosis. Professor Jacques Amar, coordinator of the arterial hypertension department at Toulouse University Hospital, insists on the need for these patients to establish a dialogue with their doctor which, in the majority of cases, makes it possible to identify the causes of this resistance.
High blood pressure despite treatment
Resistant hypertension is defined by Jacques Amar as “hypertension where blood pressure remains above blood pressure targets while the patient is receiving antihypertensive therapy, typically three drugs including a diuretic.” Concretely, this means that blood pressure remains above the recommended target of 140 and/or 90 mmHg in a sitting position despite the combination of triple hypertensive therapy and lifestyle and dietary rules.
It is essential to know how to identify what causes this resistance in order to adapt the treatment. “A lot of dialogue is needed which, in the majority of cases, will allow us to pinpoint the causes”, pleads Jacques Amar.
Take your treatment well
Initially, it is essential for the doctor to ensure that the patient takes his treatment well. “There may be side effects that lead to taking them irregularlysuggests the professor. Some hypertensives have memory problems and therefore, in fact, this will compromise the taking of medication.” It may also happen that some patients associate adverse effects with treatments without these being related and therefore the doctor plays a major role in reassuring the patient or changing medication in order to modify the patient’s perception of the treatment. this one.
Respect the hygieno-dietetic measures
The first thing for patients is to stop smoking and watch the amount of alcohol ingested. Then, Jacques Amar identifies “two pillars. What the patient eats and physical activity. You need less salt, more fruits and vegetables.” Non-compliance with these measures is an important factor of resistance and, here again, their detection requires a dialogue with the doctor so that the latter can realize whether the hygiene and dietary measures are being respected.
Causes independent of the patient’s lifestyle
There may be causes beyond the patient’s control. This can include taking other drugs that can lead to resistance, such as anti-inflammatories. “Then there are more technical causes such as hormone dosage or renal evaluation.list Jacques Amar. It is necessary to make a balance sheet and examinations which make it possible to approach the mechanisms of the resistance to adapt the treatment or to treat the cause of this resistance..”
Below, Pr Jacques Amar’s interview on resistant hypertension:
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