RESISTANT ARTERIAL HYPERTENSION: CONTEMPORARY CONCEPTS OF DIAGNOSIS, PSEUDORESISTANCE, AND THERAPEUTIC STRATEGIES

Abstract

Arterial hypertension remains one of the leading global health problems due to its high prevalence, chronic course, and major contribution to cardiovascular morbidity and mortality. Resistant arterial hypertension represents a particularly challenging clinical phenotype, characterized by the failure to achieve target blood pressure levels despite the use of combination antihypertensive therapy. This article reviews current concepts regarding the epidemiology, pathophysiology, clinical manifestations, and diagnostic criteria of resistant hypertension. Special emphasis is placed on the phenomenon of pseudoresistance, including improper blood pressure measurement, white-coat hypertension, poor medication adherence, and the influence of concomitant drugs. Approaches to the differential diagnosis of secondary hypertension and principles of rational pharmacological management are discussed. The importance of ambulatory blood pressure monitoring and patient engagement in long-term disease control is highlighted.