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This new phenotype is different from resistant hypertension (RHTN), defined as BP that is uncontrolled despite using\u2009\u2265\u20093 medications, commonly a long-acting calcium channel blocker (CCB), a blocker of the renin-angiotensin system (angiotensin-converting enzyme [ACE] inhibitor or angiotensin receptor blocker [ARB]), and a diuretic. The RHTN phenotype includes controlled RHTN, BP that is controlled on 4 or more medications. RfHTN is largely attributable to increased sympathetic activity, unlike RHTN, which is mainly due to increased intravascular fluid volume frequently caused by hyperaldosteronism and chronic excessive sodium ingestion. Compared to those with controlled RHTN, patients with RfHTN have a higher prevalence of target organ damage and do not have elevated aldosterone levels. Ongoing clinical trials are assessing the safety and efficacy of using devices to aid with BP control in patients with RfHTN.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Summary<\/jats:title>\n                <jats:p>RfHTN is a separate entity from RHTN and is generally attributable to increased sympathetic activity.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s11906-022-01185-6","type":"journal-article","created":{"date-parts":[[2022,4,6]],"date-time":"2022-04-06T11:03:01Z","timestamp":1649242981000},"page":"225-234","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":49,"title":["An Update on Refractory Hypertension"],"prefix":"10.1007","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6211-6656","authenticated-orcid":false,"given":"Faris","family":"Matanes","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0546-8975","authenticated-orcid":false,"given":"M. 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All authors have approved the final version of this manuscript.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for Publication"}},{"value":"Faris Matanes reports grants from NIH during the conduct of the study. Suzanne Oparil declares the following Editor-in-Chief, Current Hypertension Reports (Journal; Publisher \u2013 Springer Science Business Media LLC); annual stipend of $5,000 (Springer); Editor-in-Chief Term until 12\/2022. M. Bilal Khan, Mohammed Siddiqui, Tanja Dudenbostel, and David Calhoun declare that they have no conflict of interest.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of Interest"}},{"value":"This article does not contain any studies with human or animal subjects performed by any of the authors.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Human and Animal Rights and Informed Consent"}}]}}