When blood pressure is hard to treat
Resistant hypertension means that blood pressure remains above goal even after taking at least three different types of high blood pressure drugs.

IF you're having trouble getting your blood pressure under control, you're not alone.

Many people still have high blood pressure despite being treated for it. It's called resistant hypertension — and it means that blood pressure remains above goal even after taking at least three different types of high blood pressure drugs.

It's estimated that nearly one in six adults treated for high blood pressure in the US has resistant hypertension. If you're one of them, don't give up. There are several steps you can take to lower your blood pressure.

Start with the advice below, from Mayo Clinic experts.

Rule out external factors

If you're experiencing resistant hypertension, start by ruling out external factors that can affect your blood pressure readings. These may include:

White coat hypertension. About 15 per cent to 30 per cent of people with hypertension have white coat hypertension. This means their blood pressure increases at the doctor's office but goes back down when they're at home.

Monitoring blood pressure at home for a period of time can help evaluate what overall blood pressure is really like.

A health condition. It may be that another condition — like sleep apnoea or kidney problems — is causing high blood pressure. In this case, treating the underlying problem usually helps improve blood pressure.

Insufficient medication. Research suggests that only about half of people with resistant hypertension receive optimal treatment for high blood pressure.

Your doctor, hypertension specialist or pharmacist can help assess whether your current high blood pressure medications and doses are appropriate.

Take a close look at lifestyle choices

Often, poorly controlled high blood pressure that appears to be resistant to treatment actually stems from not making the changes necessary to lower hypertension.

If your blood pressure hasn't responded to drug therapy, ask yourself these questions:

Have I been taking my medication exactly as prescribed? If you don't take your medication as your doctor ordered, it may not work as it should.

Have I cut down on sodium? Even if you aren't salting your foods, you may be eating processed foods with too much sodium. Eat unprocessed whole foods more often.

Am I drinking too much alcohol? Alcohol can keep your blood pressure elevated, especially if you drink large amounts in a short time. Your medication may not be able to overcome the effects of alcohol, and alcohol may interfere with the drug.

Have I seriously tried to stop smoking? Like alcohol, tobacco products can keep blood pressure persistently high if you use them frequently.

Have I gained weight? Generally, losing weight decreases your blood pressure. Weight gain — as few as 10 pounds (4.5 kilograms) — can increase blood pressure and make it harder to control.

Have I been sleeping well? Sleep apnoea can raise your blood pressure. Relieving sleep apnoea can help lower your blood pressure.

Other options for resistant hypertension

If lifestyle changes don't work to lower your blood pressure, you still have options. This might include adding a fourth drug to your regimen or increasing the dosage of your current medication.

If you and your doctor can identify what's behind your persistently high blood pressure, there's a good chance you can meet your blood pressure goals.

This article originally appeared on Mayo Clinic website. Read more at mayoclinic.org

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