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Resistant Hypertension and High Blood Pressure

Updated on May 1, 2011

A new hard-to-treat, dangerous type of hypertension is becoming increasingly prevalent. It is known as Resistant Hypertension. Prime causes of Resistant Hypertension are:

  1. Disease progression
  2. Inaccurate Blood Pressure measurement
  3. White coat hypertension
  4. Suboptimal treatment
  5. Non-compliance with prescribed therapy
  6. Coexisting conditions
  7. Secondary hypertension

The New Reading

Blood Pressure (BP) is the amount of force that blood exerts on the walls of blood vessels as it travels through the circulatory system. Blood doesn’t travel in a steady flow. Instead, it is propelled through the blood vessels with the force of every heart beat. Each time the heart contracts – a phenomenon known as ‘systole’ – BP rises as more blood is forced through the arteries. Every ‘systole’ is followed by a movement of relaxation, known as ‘diastole’, when BP drops as the heart refills with blood and rests before the next contraction.

If your BP is 140/90 mm Hg which is a commonly accepted threshold for hypertension – this means that you’ve a systolic pressure of 140 mm Hg and a diastolic pressure of 90 mm Hg. Controlling high BP can be challenging. Resistant Hypertension is a condition in which BP stays above the clinical goal despite treatment with three or more different classes of Blood Pressure medications. Because Resistant Hypertension often persists for years or even decades, it can be even more damaging than other form of hypertension and can dramatically increase the risk of heart attacks and strokes.

Typically, Resistant Hypertension is defined as BP that cannot be brought below 140/90 mm Hg – or below 130/80 mm Hg in patients with diabetes or kidney problems – in spite of a maximized three-drug regimen that includes a diuretic.

You can check your BP at your home with a home BP monitor. Read the article “How to Buy a Home Blood Pressure Monitor” for more information.

Blood Pressure: Why is it so important?

Every organ and tissue is your body requires constant supply of blood. It provides the necessary oxygen and nutrients your body needs to perform the normal functions. It also helps to dispose of the waste products that result from these functions.

To meet these requirements your heart has to pump blood through about 60,000 miles of blood vessels. This blood vessels maze is more than twice the Earth’s circumference. To navigate it, a certain amount of force is required to propel blood through the body and return it to the heart. BP or Blood Pressure is that force.

Our body generates Blood Pressure in two main ways:

A) Blood flowing through the arteries (vessels that carry blood from the heart to the tissues) creates pressure. The more blood the heart pumps with each heart beat, the greater the amount of blood flowing through the arteries and thus more pressure against the artery walls.

B) The arteries themselves create pressure by resisting blood flow. Small arteries contain smooth muscle cells which contract and expand like any other muscle in your body. When these muscles contract the openings in the arteries becomes smaller and the pressure of blood flowing through these arteries increases.

Blood Pressure Category 
Systolic Blood Pressure 
Diastolic Blood Pressure
<120 mm Hg
<80 mm Hg 
Lifestyle measures not recommended. 
120-139 mm Hg
80-89 mm Hg
Lifestyle measures only. If the patient has diabetes or kidney disease, he may need to take medication to lower his BP to less than 130/88 mm Hg.
Stage 1  Hypertension
140-159 mm Hg
90-99 mm Hg
Lifestyle measures. Blood Pressure medication is also required - usually a thiazide diuretic. Other types of Blood Pressure medication may be considered if the patient has heart disease, diabetes, kidney problems, or if he had a stroke.
Stage 2 Hypertension 
>160 mm Hg
>100 mm Hg
Lifestyle measures. Also, two Blood Pressure medications are typically required - usually a thiazide diuretic in combination with an ACE inhibitor, angiotensin II receptor blocker, beta blocker, or calcium channel blocker. Other types of Blood Pressure medication may be considered if the patient has heart disease, diabetes, kidney problems, or if he had a stroke.
Reduce Sodium Intake
Reduce Sodium Intake

Blood Pressure and You:

The amount of pressure required to circulate blood varies according to your body’s needs. When you’re sitting still or sleeping your body needs less blood than when you’re doing strenuous work or working out. A complex mix of hormones and nerves regulates blood flow in response to your body’s varying requirements.

In many people this regulatory system goes awry and BP remains persistently high, even at rest, resulting in a condition called high Blood Pressure, or hypertension. High BP is one of the main reasons of heart attacks or cerebral strokes.

To determine your BP category, average your BP readings from at least two doctor visits. An average reading of 165/95 mm Hg BP implies that you’ve stage 2, not stage 1 hypertension.

Lifestyle measures to keep BP under control are recommended for all, even those with normal level of BP and those taking medication to manage hypertension. Lifestyle measures include losing weight if needed, following the Dietary Approaches to Stop Hypertension (DASH) diet, reducing sodium intake and increasing potassium intake, increased physical activity, limiting alcohol consumption, and quitting smoking.

You can read the article "8 Effective Tips to control High Blood Pressure & Resistant Hypertension" for more information.


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    • andycool profile image

      andycool 6 years ago from the U.S.

      Thanks Sam9999 for your supportive comment! Your positive feedback is my inspiration to write more such hubs. Love & Peace :)

    • Sam9999 profile image

      Sam9999 6 years ago

      Very informative Hub. You put a lot of thought into writing this article.

    • andycool profile image

      andycool 6 years ago from the U.S.

      Thanks Mrs. J. B. for your support! I really appreciate it. I pray to the Almighty for your and your near and dear ones' good health... be happy today and always remain so! - andycool

    • Mrs. J. B. profile image

      Mrs. J. B. 6 years ago from Southern California

      This was so interesting. Also if I ever get really sick, I will be calling on you!!!!