Refractory Hypertension

Refractory hypertension is called resistant hypertension by some medical experts, but we hold that it is better to call it refractory hypertension. In recent years, JNC7, Europe's prevention and cure guide of hypertension as well as China's prevention and cure guide of hypertension has revised diagnostic code of hypertension. Combining some authority guidelines, we give the definition as the following: refractory hypertension is the failure to reach goal BP(<140/90 mmHg and <130/80 mmHg for patients with diabetes or chronic kidney disease) in patients who are adhering to full dose of an appropriate three-drug regimen that includes a diuretic. Because past diagnostic criteria is non-uniform, it is difficult to count up the ratio of refractory hypertension. Some scholars report that the ratio is about 5%~8%. Our statistics shows that the ratio of refractory hypertension in out-patient department is about 20%, but in in-patient department it is about 30%~40%.The causes of refractory hypertension are: malpractice, drug intolerance, secondary hypertension, white-coat hypertension, psychological factors, heavy smoking and alcohol abuse, sleep apnea syndrome,...