Factors Contributing to Resistant Hypertension Cardiac Considerations

SUMMARY Medical treatment of hypertension has beneficial effects in the prevention of complica-tions of the disease and in prolongation of survival. Nevertheless, the control of hypertension may sometimes be difficult. In this respect, the heart itself may interfere with blood pressure control because of increased cardiac output or because of cardlogenic reflexes that could conceivably not only initiate but also perpetuate peripheral vasoconstriction. The resultant persistence of hypertension may induce further cardiac changes that will in turn perpetuate the rise in blood pressure. (Hypertension 11 [Suppl II]: II-84-II-87, 1988) KEY WORDS • resistant hypertension • heart • blood pressure THERE is no doubt that successful medical treat-ment of hypertension has had beneficial ef-fects in the prevention of complications of this disease and resulted in prolongation of survival. Flexi-bility in the choice of drugs and in adjustment of doses has been made possible by the availability of multiple new effective medications that have specific patho-physiological mechanisms of action. Moreover, long-acting specific therapeutic agents have helped improv