2024-04-07 07:53:18
Many high blood pressure patients take multiple medications to control the condition. But sometimes that’s not enough.
Millions of Germans suffer from high blood pressure and take antihypertensive drugs every day to regulate their levels. It can be frustrating for those affected when they realize that despite medication, their blood pressure is not being reduced sufficiently. So-called treatment-resistant high blood pressure can have various causes – and there are different ways to deal with it.
Important
Treatment-resistant high blood pressure occurs when the usual treatment does not work sufficiently – i.e. the blood pressure target value agreed with the doctor is not reached, even though three different antihypertensive drugs have already been prescribed in the highest tolerated dose. As a rule, these are an ACE inhibitor or a sartan, a calcium channel blocker and a thiazide-like diuretic such as chlorthalidone or indapamide.
High blood pressure: new guidelines for dealing with medication
The official patient guidelines on high blood pressure have now been revised. For the first time, it provides answers to the question of what to do if therapy doesn’t work. For example, those affected should check, in consultation with their doctor,
- whether the medication is taken correctly,
- whether the dose should be adjusted or
- whether switching to other active ingredients makes sense.
Possible comorbidities should also be clarified by a doctor. According to the guidelines, sleep apnea, thyroid or kidney diseases and hormonal disorders can be behind the high values.
Other reasons why antihypertensives don’t work
A common problem is therefore non-adherence. This means that patients find it difficult to take their prescribed medication every day. The pharmacy staff can provide support here and, for example, offer dosettes or reminder aids.
The cause of therapy-resistant high blood pressure could also be noticed in a medication analysis: Other medications could weaken the effect of the antihypertensive drugs or increase blood pressure themselves. This often happens with corticosteroids (agents containing cortisone). In such a case, the doctor must decide what steps to take.
Lowering blood pressure: medications and lifestyle adjustments
Last but not least, it should be checked whether the non-medicinal measures are being sufficiently adhered to. To successfully treat high blood pressure, patients should reduce their salt consumption, eat a healthy diet and get plenty of exercise. Smoking, alcohol and energy drinks can also have a negative effect on blood pressure. Here you can read more about it.
In general, the patient guidelines advise that you, as those affected, speak openly and honestly with your doctor about any concerns you may have to ensure that you receive the right treatment. “It’s not about criticizing you, but about helping you and looking for solutions together,” it says. Only when all causes have been ruled out or eliminated should the therapy be expanded to include another medication. An additional long-term blood pressure measurement is recommended beforehand.