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Factors Contributing to Resistant Hypertension/Risk Factors
for Resistant Hypertension
Lifestyle Factors
- Obesity
- Excess alcohol intake
- Excess dietary sodium
Drug-Related Causes (Short-Circuiting Pharmacological Actions, Sodium
Retention and Others)
Patients themselves can be taking drugs, formally or informally, which can interfere
with antihypertensive medications or be pressor (3).
- Non-steroidal anti-inflammatory drugs.
- Contraceptive hormones—combined oral contraceptives are more often associ-
ated with elevated blood pressure, whereas menopausal hormone therapy has
minimal effects on blood pressure. - Adrenal steroid hormones.
- Sympathomimetic agents (nasal decongestants, diet pills).
- Erythropoietin, cyclosporine and tacrolimus.
- Liquorice (suppresses the metabolism of cortisol).
- Herbal supplements (ephedra, bitter orange, etc.).
- Cocaine and amphetamines misuse.
Chronic Volume Overload
- Impaired, and declining, kidney function
- High salt intake
- Inadequate diuretic therapy
Suboptimal therapy is usually represented by failure to use an adequate diuretic
therapy and lack of properly selected drugs and dosage.
D. Goldsmith and S. Badarau