{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,4,24]],"date-time":"2024-04-24T11:31:34Z","timestamp":1713958294272},"reference-count":16,"publisher":"Oxford University Press (OUP)","issue":"Supplement_I","license":[{"start":{"date-parts":[[2022,11,12]],"date-time":"2022-11-12T00:00:00Z","timestamp":1668211200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,11,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Resistant hypertension consists in the failure to achieve effective control of blood pressure despite the use of at least three drugs, including a diuretic, at the maximum tolerated dosage. Despite the progress made in terms of improving awareness and effectiveness of the available therapeutic strategies, the percentage of patients with resistant hypertension represents up to 18% of the entire hypertensive population. The management of resistant hypertension includes the combination of different strategies from lifestyle changes to complex interventional procedures. Lifestyle interventions include reducing salt intake, weight loss, quitting smoking and alcohol consumption, and performing aerobic physical activity. With regard to drug therapy, international guidelines recommend the introduction of a mineralocorticoid receptor antagonist or, if not tolerated, of a loop diuretic, or of the beta-blocker bisoprolol, or of the alpha-blocker doxazosin. In the last few years, promising results have been obtained from studies that have evaluated the efficacy and safety of the denervation of the renal arteries by ablation. This procedure may constitute an increasingly widespread option for those patients suffering from resistant hypertension despite the use of different drug classes, or who are intolerant or poorly adherent to medical therapy.<\/jats:p>","DOI":"10.1093\/eurheartjsupp\/suac094","type":"journal-article","created":{"date-parts":[[2022,11,12]],"date-time":"2022-11-12T15:20:03Z","timestamp":1668266403000},"page":"I197-I200","source":"Crossref","is-referenced-by-count":1,"title":["The enigma of resistant hypertension: from lifestyle changes and pharmacological treatment to renal denervation"],"prefix":"10.1093","volume":"24","author":[{"given":"Massimo","family":"Volpe","sequence":"first","affiliation":[{"name":"Department of Clinical and Molecular Medicine, Sapienza University of Rome, Sant\u2019Andrea Hospital , Rome"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giovanna","family":"Gallo","sequence":"additional","affiliation":[{"name":"Department of Clinical and Molecular Medicine, Sapienza University of Rome, Sant\u2019Andrea Hospital , Rome"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2022,11,12]]},"reference":[{"key":"2022111417541602400_suac094-B1","doi-asserted-by":"crossref","first-page":"3021","DOI":"10.1093\/eurheartj\/ehy339","article-title":"2018 ESC\/ESH guidelines for the management of arterial hypertension","volume":"39","author":"Williams","year":"2018","journal-title":"Eur Heart J"},{"key":"2022111417541602400_suac094-B2","doi-asserted-by":"crossref","first-page":"e53","DOI":"10.1161\/HYP.0000000000000084","article-title":"Resistant hypertension: detection, evaluation, and management: a scientific statement from the American Heart Association","volume":"72","author":"Carey","year":"2018","journal-title":"Hypertension"},{"key":"2022111417541602400_suac094-B3","doi-asserted-by":"crossref","first-page":"1635","DOI":"10.1161\/CIRCULATIONAHA.111.068064","article-title":"Incidence and prognosis of resistant hypertension in hypertensive patients","volume":"125","author":"Daugherty","year":"2012","journal-title":"Circulation"},{"key":"2022111417541602400_suac094-B4","doi-asserted-by":"crossref","first-page":"622","DOI":"10.1038\/ki.2015.142","article-title":"Comparative risk of renal, cardiovascular, and mortality outcomes in controlled, uncontrolled resistant, and nonresistant hypertension","volume":"88","author":"Sim","year":"2015","journal-title":"Kidney Int"},{"key":"2022111417541602400_suac094-B5","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1097\/HJH.0000000000000023","article-title":"Dynamic resistant hypertension patterns as predictors of cardiovascular morbidity: a 4-year prospective study","volume":"32","author":"Tsioufis","year":"2014","journal-title":"J Hypertens"},{"key":"2022111417541602400_suac094-B6","doi-asserted-by":"crossref","first-page":"817","DOI":"10.1111\/jch.12773","article-title":"Blood pressure control provides less cardiovascular protection in adults with than without apparent treatment-resistant hypertension","volume":"18","author":"Egan","year":"2016","journal-title":"J Clin Hypertens"},{"key":"2022111417541602400_suac094-B7","first-page":"CD008274","article-title":"Long-term effects of weight-reducing diets in people with hypertension","volume":"3","author":"Semlitsch","year":"2016","journal-title":"Cochrane Database Syst Rev"},{"key":"2022111417541602400_suac094-B8","doi-asserted-by":"crossref","first-page":"1588","DOI":"10.1093\/eurheartj\/ehaa121","article-title":"Proceedings from the 3rd European Clinical Consensus Conference for clinical trials in device-based hypertension therapies","volume":"41","author":"Mahfoud","year":"2020","journal-title":"Eur Heart J"},{"key":"2022111417541602400_suac094-B9","doi-asserted-by":"crossref","first-page":"911","DOI":"10.1161\/HYPERTENSIONAHA.110.163014","article-title":"Catheter-based renal sympathetic denervation for resistant hypertension: durability of blood pressure reduction out to 24 months","volume":"57","author":"Symplicity HTN-1 Investigators","year":"2011","journal-title":"Hypertension"},{"key":"2022111417541602400_suac094-B10","doi-asserted-by":"crossref","first-page":"1903","DOI":"10.1016\/S0140-6736(10)62039-9","article-title":"Renal sympathetic denervation in patients with treatment-resistant hypertension (the Symplicity HTN-2 trial): a randomised controlled trial","volume":"376","author":"Symplicity HTN-2 Investigators","year":"2010","journal-title":"Lancet"},{"key":"2022111417541602400_suac094-B11","doi-asserted-by":"crossref","first-page":"1393","DOI":"10.1056\/NEJMoa1402670","article-title":"A controlled trial of renal denervation for resistant hypertension","volume":"370","author":"Bhatt","year":"2014","journal-title":"N Engl J Med"},{"key":"2022111417541602400_suac094-B12","doi-asserted-by":"crossref","first-page":"743","DOI":"10.1093\/eurheartj\/ehy871","article-title":"Ambulatory heart rate reduction after catheter-based renal denervation in hypertensive patients not receiving anti-hypertensive medications: data from SPYRAL HTN-OFF MED, a randomized, sham-controlled, proof-of-concept trial","volume":"40","author":"B\u00f6hm","year":"2019","journal-title":"Eur Heart J"},{"key":"2022111417541602400_suac094-B13","doi-asserted-by":"crossref","first-page":"2346","DOI":"10.1016\/S0140-6736(18)30951-6","article-title":"Effect of renal denervation on blood pressure in the presence of antihypertensive drugs: 6-month efficacy and safety results from the SPYRAL HTN-ON MED proof-of-concept randomised trial","volume":"391","author":"Kandzari","year":"2018","journal-title":"Lancet"},{"key":"2022111417541602400_suac094-B14","doi-asserted-by":"crossref","first-page":"2335","DOI":"10.1016\/S0140-6736(18)31082-1","article-title":"Endovascular ultrasound renal denervation to treat hypertension (RADIANCEHTN SOLO): a multicentre, international, single-blind, randomised, sham controlled trial","volume":"391","author":"Azizi","year":"2018","journal-title":"Lancet"},{"key":"2022111417541602400_suac094-B15","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1007\/s40292-020-00367-0","article-title":"Italian Society of Arterial Hypertension (SIIA) position paper on the role of renal denervation in the management of the difficult-to-treat hypertensive patient","volume":"27","author":"Bruno","year":"2020","journal-title":"High Blood Press Cardiovasc Prev"},{"key":"2022111417541602400_suac094-B16","doi-asserted-by":"crossref","first-page":"3474","DOI":"10.1093\/eurheartj\/ehz118","article-title":"Effects of renal denervation on kidney function and long-term outcomes: 3-year follow-up from the Global SYMPLICITY Registry","volume":"40","author":"Mahfoud","year":"2019","journal-title":"Eur Heart J"}],"container-title":["European Heart Journal Supplements"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/eurheartjsupp\/article-pdf\/24\/Supplement_I\/I197\/47030560\/suac094.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/eurheartjsupp\/article-pdf\/24\/Supplement_I\/I197\/47030560\/suac094.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,11,14]],"date-time":"2022-11-14T17:57:19Z","timestamp":1668448639000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/eurheartjsupp\/article\/24\/Supplement_I\/I197\/6823843"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,11,12]]},"references-count":16,"journal-issue":{"issue":"Supplement_I","published-online":{"date-parts":[[2022,11,12]]},"published-print":{"date-parts":[[2022,11,12]]}},"URL":"https:\/\/doi.org\/10.1093\/eurheartjsupp\/suac094","relation":{},"ISSN":["1520-765X","1554-2815"],"issn-type":[{"value":"1520-765X","type":"print"},{"value":"1554-2815","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2022,11,12]]},"published":{"date-parts":[[2022,11,12]]}}}