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Resistant hypertension is defined as hypertension that remains above goal blood pressure in spite of using, at once, three antihypertensive medications belonging to different drug classes. Guidelines for treating resistant hypertension have been published in the UK [45] and US. [46]
Guidelines on the choice of agents and how best to step up treatment for various subgroups in hypertension (high blood pressure) have changed over time and differ between countries. A Comparison of International Guidelines on Goal Blood Pressure and Initial Therapy for Adults With Hypertension (adapted from JNC 8 guidelines [ 1 ] )
Adequate management of hypertension can be hampered by inadequacies in the diagnosis, treatment, or control of high blood pressure. [185] Health care providers face many obstacles to achieving blood pressure control, including resistance to taking multiple medications to reach blood pressure goals.
[42] [43] Hydralazine and its derivatives are also used in the treatment of severe hypertension, although they should be avoided in emergencies. [43] They are no longer indicated as first-line therapy for high blood pressure due to side effects and safety concerns, but hydralazine remains a drug of choice in gestational hypertension. [42]
The dangerous effects of high blood pressure are highlighted in a new report by the World Health Organization that identifies the condition as one of the world’s leading risk factors for death ...
Soluble guanylate cyclase (sGC) stimulators are a class of drugs developed to treat heart failure, pulmonary hypertension, and other diseases. The first-in-class medication was riociguat, approved in 2013 for pulmonary hypertension. [1] [2] They have also been investigated for hypertension, systemic sclerosis, and sickle cell disease. [3] [1]
Medication Antihypertensives Severely elevated blood pressure (equal to or greater than 180 mmHg systolic or 120 mmHg diastolic ) is referred to as a hypertensive crisis (sometimes termed malignant or accelerated hypertension), due to the high risk of complications.
A hypertensive emergency is very high blood pressure with potentially life-threatening symptoms and signs of acute damage to one or more organ systems (especially brain, eyes, heart, aorta, or kidneys). It is different from a hypertensive urgency by this additional evidence for impending irreversible hypertension-mediated organ damage (HMOD).