Hard to Treat High Blood Pressure: What You Can Do

Victoria Burke by Victoria Burke | Licensed since 2011
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This article was updated on: 09/15/2018

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According to the Centers for Disease Control and Prevention (CDC), about one out of three people in America have been diagnosed with high blood pressure. Although about 50% of the population can control high blood pressure through standard medical treatment, uncontrolled high blood pressure can cause irreversible kidney damage reports the National Institute of Diabetes, Digestive and Kidney Diseases. In addition to chronic kidney disease, uncontrolled high blood pressure can increase the risk of heart disease and stroke, explains Dr. Naomi D.L. Fisher, director of the Hypertension Service at Harvard-affiliated Brigham and Women’s Hospital.

What is hard-to-treat high blood pressure?

Also known as “resistant hypertension” hard-to-treat high blood pressure does not respond well to medical treatment. According to Johns Hopkins Medicine, high blood pressure is considered hard to treat or resistant when all of the following are true:

  • Someone is taking three different high blood pressure medications at their maximally tolerated doses.
  • One of the high blood pressure medications is a diuretic (removes fluid and salt from the body).
  • Blood pressure remains uncontrolled—higher than 140/90.

What causes resistant high blood pressure?

In about 25% of people with resistant high blood pressure, explains Johns Hopkins Medicine, there’s an identifiable, or secondary, cause. People whose blood pressure is raised by a medical condition are said to have secondary hypertension. Secondary hypertension will be very hard to control until those conditions are addressed.

According to the American Heart Association, some of the common medical conditions that can cause high blood pressure include:

  • Abnormalities in the hormones that control blood pressure.
  • The accumulation of artery-clogging plaque in blood vessels that nourish the kidneys, a condition called renal artery stenosis.
  • Sleep problems, such as obstructive sleep apnea.
  • Obesity or heavy intake of alcohol or other substances that can interfere with blood pressure.

In the other 75% of people with hard-to-treat high blood pressure, there is no known medical cause explains Johns Hopkins Medicine. These people are said to have primary or essential hypertension, and their treatment usually focuses on finding effective medication and lifestyle management.

How is hard-to-control high blood pressure treated?

Treatment options for resistant high blood pressure depend on your underlying conditions and how well you tolerate various medications. The American Heart Association notes that your high blood pressure treatment is likely to involve one or a combination of the following:

  • Addressing any underlying conditions that may be causing high blood pressure
  • Changing medications to control high blood pressure
  • Modifying your lifestyle to include a low-salt diet and physical activity

What can you do to help manage your high blood pressure?

Cleveland Clinic’s hypertension specialist George Thomas, MD. suggests 8 tips to help people manage their high blood pressure.

  1. Make sure you’re taking your high blood pressure medication correctly and at the scheduled time.
  2. If your medication is causing unpleasant side effects, talk to your doctor about alternatives — don’t just stop taking it.
  3. Follow a low-sodium diet (less than 2.3 grams per day).
  4. Follow the DASH diet, which includes lots of fruits, vegetables, whole grains and lean protein.
  5. Limit the amount of processed foods you eat — they’re usually high in sodium.
  6. Exercise regularly. (Talk to your doctor first if it’s been awhile since you were physically active.)
  7. Limit your alcohol intake.
  8. Learn to check your blood pressure at home. Ask your doctor to help you create a monitoring schedule. Log the results and bring them to your doctor’s appointments. Have your blood pressure machine checked for accuracy at least once a year.

Do you have further questions about resources on high blood pressure treatment and things you can do to help control it?  Would you like help understanding how and when Medicare covers high blood pressure?  I would be happy to help you.

  • To get some more Medicare plan information to review, use the links below; you can schedule a phone call with me or have me email you plan options available through eHealth.
  • If you’d like to compare some of the Medicare plans, use the Compare Plans button on this page.

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