Resistant hypertension occurs when the body is resistant to drugs. dangerous?

High blood pressure, aka hypertension, is one of the most common health problems in the world. However, that doesn't mean you can underestimate hypertension. If not treated properly, hypertension has the potential to cause heart failure and stroke. However, some people may not respond to the effects of the hypertension drugs they have been using. This type of drug-resistant hypertension is known as resistant hypertension.

What is resistant hypertension?

A person is said to have resistant hypertension when their blood pressure tends to stay at a high limit or more than 140/90 mmHg, even though they have taken three different types of hypertension drugs, one of which is a diuretic.

Diuretic drugs indeed play the most important role in lowering blood pressure and determining whether a person has resistant hypertension. The reason is, this drug works by removing fluid and salt content from the body which is one of the causes of high blood pressure.

A person is also said to have resistant hypertension if they need four or more high blood pressure medications to control blood pressure.

Resistant hypertension is the most common disorder experienced by people with hypertension. Reporting from Johns Hopkins Medicine, at least, about 20 percent of people with hypertension experience resistant hypertension or drug resistant hypertension.

Although common, this condition cannot be underestimated. The reason is, blood pressure that is difficult to control due to resistant hypertension can increase the risk of heart dysfunction and stroke.

What causes this drug resistant hypertension?

Most of the hypertension and resistant hypertension occur due to unhealthy lifestyles, such as eating foods high in sodium (salt), not actively moving or exercising, consuming excessive alcohol, and smoking. Obesity or overweight can be one of the contributing factors.

In addition, mistakes in taking hypertension medication and the use of certain drugs, such as pain relievers, especially nonsteroidal antiinflammatory drugs/ NSAIDs, nasal decongestants, oral contraceptives, or herbal medicines, can also cause you to become resistant to high blood pressure medications. These drugs are said to have interactions with hypertension drugs, thus inhibiting their work in lowering blood pressure.

On the other hand, resistant hypertension can also occur due to other underlying medical conditions. In this condition, doctors usually will investigate secondary causes that keep your blood pressure high. The following medical conditions you may experience:

Hormonal disturbances

Primary aldoteronism, namely an adrenal gland disorder that occurs due to the production of the hormone aldosterone too much and causes high blood pressure.
Pheochromocytoma, is a tumor of the adrenal gland that causes the production of the hormone adrenaline to over-produce, which increases blood pressure.
Cushing's syndrome, which is characterized by a tumor in the pituitary gland and results in an overproduction of the hormone cortisol or the stress hormone.
Thyroid disorders, either hyperthyroid or hypothyroid.
Other endocrine disorders.

Structural disturbances

Sleep apnea, which causes breathing to stop momentarily during sleep.
Renal artery stenosis, which is narrowing of the arteries that carry blood to the heart.
Narrowing of the large artery (aorta) that plays a role in carrying blood from the heart to the rest of the body.
Kidney failure.

What are the symptoms that might be felt?

Basically, high blood pressure or hypertension does not cause any symptoms. Therefore, this condition is often referred to as a silent killer because it can threaten a person's life if not treated immediately.

This also occurs in someone who has resistant hypertension. A person with drug-resistant hypertension generally does not feel any symptoms of hypertension.

Usually, symptoms will appear when a person has very high blood pressure, which reaches 180/120 mmHg or what is called a hypertensive crisis. When this happens, generally a person will feel headaches, dizziness, shortness of breath, and other symptoms. A person with a hypertensive crisis needs to get emergency medical care.

How do I know I have resistant hypertension?

To find out whether you have resistant hypertension or not, your doctor will generally ask you a detailed history of high blood pressure, including overall drug use, and a physical examination to see if there is anything abnormal in your physique.

In addition, other examinations may also be carried out, some of which are:

Blood pressure measurement.
24-hour blood pressure monitoring using an ambulatory blood pressure gauge.
Examination of secondary diseases and organ damage that is a complication of hypertension, such as:
- Electrocardiogram (EKG)
- Echocardiogram
- Fundoscopy or ophthalmoscopy
- Urine test
- Blood test
- Chest X-ray

How to treat people with resistant hypertension?

Understanding the causes of resistant hypertension is the first step in dealing with it. If the resistance you experience is due to certain medical conditions, treatment needs to be started from overcoming the disease.

Whereas if it occurs because of an error taking medication or taking medication that is not in accordance with the provisions, the doctor will ask you to take the medicine correctly. You need to take hypertension medication every day, according to the dosage and the time requirements that the doctor has given you. You also should not stop or change hypertension medication without the doctor's knowledge.

Your doctor may also change your hypertension medication if previous medications don't work, including if you experience side effects from previous medications. In addition, as much as possible avoid certain drugs that trigger an increase in blood pressure. If absolutely necessary, consult your doctor first.

It is very important for all people with high blood pressure to adopt a healthy hypertension lifestyle, such as the DASH diet. Especially if the resistant hypertension you experience occurs due to a bad lifestyle, this can also help you prevent hypertension from getting worse.