Abstract
Hypertension (HTN) is a significant health concern, with a recent increase in HTN-related cardiovascular deaths in the United States. Refractory hypertension, a form of treatment-resistant HTN, poses a challenge for physicians and patients due to its association with increased morbidity and mortality.
Risk factors for refractory HTN include African ancestry, female gender, younger age, diabetes mellitus, obesity, obstructive sleep apnea, chronic kidney disease, end-stage renal disease, and smoking. While the exact pathophysiology of refractory HTN is not fully understood, sympathetic overdrive appears to be a significant contributing factor. Arterial stiffness, chronic kidney disease, obstructive sleep apnea, obesity, and diabetes mellitus are comorbid conditions associated with increased sympathetic activity and refractory HTN.
The knowledge behind carotid sinus stimulation suggested promising outcomes due to the known physiology. However, the introduction of devices, surgical complications, and the development of new antihypertensive soon took over the innovation of these devices. The authors aim to highlight three important aspects related to refractory hypertension: the risk factors for the development of refractory hypertension, the role of surgery in managing hypertension, and the referral systems available for the management of refractory hypertension.
Recommended Citation
Nwosu, Ifeanyi; Oladiran, Oreluwa; Rivera, Marlon Eliu; Oladiran, Oluwasegun; Nwosu, Anthony; Dim, Chinedu; and Enumah, Chibuike Patrick
(2024)
"A Review of the Risk Factors and Management of Refractory Hypertension: The Role of Carotid Sinus Stimulation and Renal Nerve Denervationhypertension, resistant, resistant hypertension, hypertension treatment, nerve ablation, treatment resistant hypertension, carotid sinus stimulation,"
Journal of Community Hospital Internal Medicine Perspectives: Vol. 14:
Iss.
4, Article 4.
DOI: 10.55729/2000-9666.1364
Available at:
https://scholarlycommons.gbmc.org/jchimp/vol14/iss4/4
