• A patient has resistant hypertension if they are not able to reach a normal arterial pressure even when they are being treated with a combination of 3 or more different medications using adequate doses.
• An expert from Spain will share with physicians from the entire Caribbean region his experience managing patients with resistant hypertension, within the framework of the Caribbean Cardiology Congress.
Trinidad and Tobago. July 2011- A patient is diagnosed with resistant hypertension when he/she is not able to reach normal blood pressure levels even when being treated with a combination of three or more different anti-hypertensive medications. Currently there are no specific studies on the prevalence of this situation; however, the American Heart Association suggests that between 20 and 30 out of every 100 diagnosed patients can be resistant to treatment ; thus the need and importance of seeing these patients in a timely manner.
Specifically to address this issue, Dr. Cesar Cerezo, a specialist in Family Medicine in the Hypertension Unit at the 12 de Octubre Hospital in Madrid, will share his experience attending these patients with the general practitioners, internists and cardiologists who will be participating in the Caribbean Cardiology Congress which will take place from July 21 to 23, 2011 in Trinidad and Tobago.
During his lecture, the Spanish specialist will explain that it is possible to offer patients with resistant hypertension a treatment allowing them to improve their quality of life, and to achieve this, the physician must determine if there is real resistance, what could have possibly caused the illness and check to see if there is any damage to organs such as lungs, liver, stomach and kidneys.
How to diagnose resistant hypertension?
Resistant hypertension may be a product of not following the treatment as was prescribed by the physician. It can also appear when there is an increase in arterial pressure levels due to other illnesses or whenever the organism is not responding to the medications in their recommended doses. A sedentary lifestyle and excessive salt consumption are other factors to take into account.
A complete clinical history can help in having details about the duration, seriousness and evolution of hypertension, as well as the treatment, levels of therapeutic adherence and response to other treatments used in the past. It can also help evaluate symptoms and possible causes and consequences of hypertension, such as sleep apnea or narrowing of the renal artery.
How to treat resistant hypertension?
The first very important step is for the patient to modify his/her lifestyle (weight control , regular physical activity , following a diet rich in fiber and low in fat and salt ), to control other medical conditions associated to hypertension and following treatment with effective medications.
It is important to point out that pharmacologic treatment that a patient with hypertension takes must be simplified as much as possible by encouraging using a combination of long term medications focused on decreasing the number of prescribed tablets and allowing for once a day doses. This is supported by the clinical trial called ALLHAT (Treatment Study to Reduce Hypertension and Lipids to Prevent a Heart Attack), where 42 thousand patients 55 years or older with high blood pressure participated, and concluded that selecting the right medication to treat resistant hypertension is vital.
CADUET by Pfizer, the first synergic anti-hypertensive medication for hypertensive patients, which effectively controls cardiovascular risk, is one option for these patients. CADUET is the combination of almodipine with atorvastatine, two safe and effective molecules that have shown great benefits in controlling elevated blood pressure and reducing high cholesterol levels. This makes CADUET the effective combination for hypertension, preventing the majority of related cardiovascular events. This medication, which will soon be available to physicians and patients in Trinidad and Tobago, also offers greater adherence to treatment, is safe and well tolerated.