The Prevalence, Incidence, Prognosis, and Associated Conditions of Resistant Hypertension

SummaryResistant hypertension is a relevant condition gaining special attention given its clinical and economic impact. Although the true prevalence is unknown, clinical trials and population-based studies have shown that it is a common clinical problem that likely will increase in incidence with an aging and more obese population. A complex interaction of various risk factors including lifestyle, associated conditions, and identifiable secondary causes can lead to uncontrolled hypertension. Important factors including improper blood pressure measuring technique, poor medication adherence, and the white coat phenomenon can lead to pseudoresistance, or a false impression of treatment resistance, which must be excluded. Patients with true resistant hypertension have a greater risk for developing adverse cardiovascular events compared with those with controlled blood pressure, leading to an unfavorable prognosis without adequate treatment. This article reviews the current understanding of the epidemiology of resistant hypertension.