© Springer International Publishing AG 2017 343
A. Covic et al. (eds.), Resistant Hypertension in Chronic Kidney Disease,
DOI 10.1007/978-3-319-56827-0_22
Chapter 22
Resistant Hypertension and the General
Practitioner (Monitoring and Treatment)
Yalcin Solak
Patients with resistant hypertension (RH) deserve a special attention because RH is
associated with higher absolute renal and cardiovascular risks, more health-care
expenditure, and greater prevalence of secondary hypertension and target organ
damage. This translates into more human suffering and health-care dollars com-
pared with hypertension under control. Notably, the single and the most effective
way of reducing this increased cardiovascular risk is just achieving sustained blood
pressure (BP) control. Thus, this fundamental aim of hypertension management
becomes more compelling and challenging in RT patients [ 1 ].
RH is quite common. Although its prevalence varies from study to study owing
to differences in definition of RH and population characteristic, it has been reported
somewhere between 10 and 30%. Some clinical settings are associated with much
higher prevalence rates; De Nicola et al. [ 2 ] reported that approximately 38% of
the patients in a chronic kidney disease clinic had fulfilled the definition of
RH. Considering that hypertension is the most common disease worldwide and the
increasing share of RH among hypertensive patients, it’s likely that general practi-
tioners (GPs) will encounter patients with RH in their routine practice. Thus, GPs
should have the essential knowledge of monitoring and treatment of RH.
In this chapter the author will review the fundamental components of follow-up
and treatment of RH from a GP point of view.
Y. Solak (*)
Division of Nephrology, Department of Internal Medicine, Sakarya University Training and
Research Hospital, Sakarya, Turkey
e-mail: [email protected]