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An Introduction to Resistant Hypertension

An Introduction to Resistant Hypertension

Resistant hypertension or resistant high blood pressure (BP) is a health concern in which your blood pressure remains on the higher side even after undergoing extensive medical treatments. Among all types of high blood pressure, your condition would be considered as resistant, if –

  • When measuring blood pressure, your blood pressure readings continue to be high, i.e., 130/80 mmHg or above, despite taking three BP lowering pills, including one water pill (diuretic).
  • You are having either four medications or more to keep your blood pressure in control.

Causes Of Resistant Hypertension

There can be many factors contributing to resistant blood pressure, as well as other types of hypertension. These include the following –

  1. Lifestyle And Diet

  2. Lifestyle And Diet

    • Being overweight and obese
    • Living a sedentary life with negligible physical activity
    • High salt intake
    • Smoking and heavy alcohol consumption
  3. Medications

  4. MedicationsThere are certain medications, both over-the-counter and prescription that can lead to uncontrolled blood pressure. They include –

    • Pain-relieving medicines, mainly non-steroidal anti-inflammatory drugs (NSAIDs) such as naproxen and ibuprofen
    • Nasal drops
    • Birth control pills
    • Liquorice and ginseng
  5. Underlying Health Conditions

  6. Underlying Health ConditionsIn one out of four (1 in 4) people who have resistant hypertension, there is a secondary and distinguishable cause behind it. If your BP is high owing to any identifiable health condition, you have secondary hypertension. So, when talking about primary vs. secondary hypertension, this is where the difference lies. In primary high BP, there is no particular identifiable cause. On the other hand, there is an identifiable cause in secondary hypertension.

The secondary causes may include the following –

      • Hormonal Disorders

      • Hormonal Disorders
        • Primary hyperaldosteronism (a condition of the adrenal gland that leads to excessive hormone production)
        • Pheochromocytoma (adrenal gland tumor)
        • Hyperthyroidism and hypothyroidism (thyroid gland condition)
        • Cushing syndrome (a pituitary gland disorder)
      • Structural Disorders

    • Structural Disorders
      • Chronic kidney disease
      • Renal artery stenosis
      • Sleep apnea
      • Kidney failure

Resistant Hypertension – Symptoms & Complications

How to diagnose high blood pressure? People who have high blood pressure hardly show any symptoms, even for years. Thus, diagnosing high blood pressure is tricky. However, unidentified and untreated hypertension can be dangerous. So, make sure to get your blood pressure checked at regular intervals, especially if you have an underlying health condition.

However, in case your blood pressure shoots up all of a sudden, it is called a hypertensive crisis (a subset of hypertensive emergency). It is when you experience symptoms that may include the following –

  • DizzinessDizziness
  • Dizziness / giddinessPounding in your chest
  • HeadacheHeadache
  • Chest PainChest pain
  • Shortness of breathShortness of breath
  • Visual issuesVisual issues

Hypertension can lead to life-threatening complications like internal bleeding, an aortic dissection, etc., if not treated timely. Such situations need immediate medical attention.

There is one more condition called hypertensive urgency, wherein your blood pressure is high (more than 180/120), but you do not experience any symptoms.

Resistant Hypertension – Treatment

Resistant Hypertension - Symptoms & ComplicationsMonitoring hypertension continuously is important. Resistant blood pressure treatment mainly depends on any underlying health condition(s) you are suffering from and how effectively you respond to various medications. The treatment options include the following –

1. Making lifestyle changes, including –

  • Limiting salt intake
  • Limiting the consumption of alcohol
  • Avoiding NSAIDs
  • Working out for at least 30 minutes 4 to 5 days a week

2. Treating the underlying medical condition, if any.
3. Adjusting medications according to your needs.

Hypertension Fast Facts

  • Hypertension is also known as a silent killer as it barely shows any symptoms.
  • It can lead to various life-threatening conditions including renal impairment, stroke, and heart disease.
  • Around 65% of people in the age group of 60 years to 69 years suffer from high blood pressure.


Resistant hypertension can lead to further complications, or it can itself be a result of an underlying disease. Therefore, make sure to get in touch with your doctor and get your BP checked from time to time.

Note of Caution: This article is for information purpose only. Always consult your doctor in case of any blood pressure or other health-related problems.

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Comments (9)


Nice article, thanks for sharing


You have mentioned that physical activity can help to control BP. Can you suggest any specific activity that offers best results?


Essentially you can do any physical activity that gets your heart pumping. Running, brisk walking, playing sports, swimming, dance, zumba and even aerobics can help. Just make sure you do at least 30 minutes of exercise daily 5 days a week. Please note that physical activity can only help you maintain normal BP. It is not a substitute to BP medication. It is recommended to get your BP checked regularly and take medication. To find a hypertension expert near you, visit- Find a Physician


I want to know some specific foods that I eat to maintain normal BP.


These tips can be helpful for you: a. Eat potassium-rich foods like bananas, spinach, lettuce, broccoli, and cauliflower b. Eat omega-3 fatty acid-rich fishes like salmon and mackerel c. Add milk and yogurt to your diet d. Add beetroot, pomegranate and garlic to your diet as they are nitric acid-rich foods and help to lower blood pressure Remember, these foods can only act as supplements to your medication and cannot treat hypertension on their own. If you have a family history of the disease, it is recommended to visit a doctor at the earliest. To find an hypertension expert near you, visit- Find a Physician


I’ve been diagnosed with resistant hypertension for some time now. I moved to a new city due to my job and don’t know any good doctors around? Can you tell me?


You can use our “Find a Physician” service to find expert doctors near you. Visit- Find a Physician


What are some foods that are a strict ‘no-no’ for BP patients?


You should avoid eating the following foods a. Foods like packaged potato chips, flavored nuts, frozen foods, instant noodles, etc. b. Saturated and trans fat found in prepackaged, processed, frozen and canned food items c. Foods containing artificial sugar d. Pickles, as they contain high amounts of sodium It is important to know that avoiding these foods can prevent your BP from rising. But, medicines are a must for hypertension treatment. Visit a doctor for expert advice. To find a hypertension expert near you, visit- Find a Physician

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