Problem of resistant arterial hypertension in the family doctor practice

Resistant arterial hypertension is diagnosed when three antihypertensives assignment does not result in achieving target blood pressure, which for most patients is the level below 140/90 mm Hg, wherein one of the medicaments must be diuretic and all drugs must be assigned to optimal or maximum tolerated doses. Although arbitrary number required to control blood pressure drugs, the determination is very useful from the point of view of both the clinician and researcher, since it helps to identify the phenotype of resistance to a wide antihypertensive treatment and diagnostic determining tactics, such as testing or causes of secondary hypertension selection treatment. Since patients with resistant arterial hypertension have a higher probability of detection of diseases, leading to the development of secondary hypertension. These include sleep apnea, kidney disease, renal artery stenosis, primary aldosteronism. Despite the high prevalence of resistant arterial hypertension, the lack of blood pressure control is often associated with an inadequate selection of antihypertensive therapy, blood pressure misjudgment or failure of patients to medical recommendations. Therefore, before carrying out diagnostic measures necessary to consistently assess the adequacy of patients receiving therapy that inherent in the definition of resistant arterial hypertension and exclude pseudoresistance