{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T17:25:27Z","timestamp":1781630727753,"version":"3.54.5"},"reference-count":0,"publisher":"Ethnicity and Disease Inc","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Ethn Dis"],"abstract":"<jats:p>&lt;p&gt;Treatment resistant hypertension (TRH) is defined by office blood pressure (BP) uncontrolled on \u22653 or controlled on \u22654 antihypertensive medications, preferably at optimal doses and including a diuretic. Apparent (a)TRH is used when optimal therapy, adherence, and measurement artifacts are unknown. Among treated hy\u00adpertensives, ~30% of uncontrolled and 10% of controlled individuals have aTRH, with a higher prevalence in Blacks than other race-ethnicity groups. In \u226550% of aTRH patients, BP measurement artifacts (\u2018office\u2019 TRH), suboptimal regimens, or suboptimal adher\u00adence are present, ie, pseudo-resistance. While patients with \u2018office\u2019 TRH have fewer cardiovascular events than those with \u2018true\u2019 TRH, no evidence confirms that patients with suboptimal regimens or adherence are spared. Averaging several office BPs obtained with an automated monitor can reduce \u2018office\u2019 TRH. Home or ambulatory BP monitoring can identify office resistance. Prescribing \u22653 different antihypertensive medication classes, eg, thiazide-type diuret\u00adic, renin-angiotensin blocker and calcium antagonist at \u226550% of maximum recom\u00admended doses reasonably defines optimal therapy. Intensifying diuretic therapy, eg, adding an aldosterone antagonist, is effec\u00adtive for many TRH patients who are volume expanded. Clinical information, hemody\u00adnamic and renin-guided therapeutics can inform other treatment options. Attention to adverse effects, medication costs, and pill burden can improve adherence and control. Patients with aTRH and suspected second\u00adary hypertension should be evaluated. Inter\u00adfering substances or medications should be discontinued. These approaches will identify or correct the problem in ~80% of aTRH patients. Referral to a hypertension special\u00adist and newer therapeutic approaches are options for TRH patients who cannot take or do not respond to optimal therapy. &lt;em&gt;Ethn Dis. &lt;\/em&gt;2015;25(4):495-498; doi:10.18865\/ ed.25.4.495&lt;\/p&gt;<\/jats:p>","DOI":"10.18865\/ed.25.4.495","type":"journal-article","created":{"date-parts":[[2015,11,11]],"date-time":"2015-11-11T14:32:22Z","timestamp":1447252342000},"page":"495","source":"Crossref","is-referenced-by-count":11,"title":["Treatment Resistant Hypertension"],"prefix":"10.18865","volume":"25","author":[{"given":"Brent M.","family":"Egan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"18154","published-online":{"date-parts":[[2015,11,10]]},"container-title":["Ethnicity &amp; Disease"],"original-title":[],"link":[{"URL":"https:\/\/www.ethndis.org\/edonline\/index.php\/ethndis\/article\/viewFile\/242\/225","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ethndis.org\/edonline\/index.php\/ethndis\/article\/viewFile\/242\/289","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ethndis.org\/edonline\/index.php\/ethndis\/article\/download\/242\/225","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,3,8]],"date-time":"2019-03-08T17:41:50Z","timestamp":1552066910000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ethndis.org\/edonline\/index.php\/ethndis\/article\/view\/242"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,11,10]]},"references-count":0,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2015,11,10]]}},"URL":"https:\/\/doi.org\/10.18865\/ed.25.4.495","relation":{},"ISSN":["1945-0826","1049-510X"],"issn-type":[{"value":"1945-0826","type":"electronic"},{"value":"1049-510X","type":"print"}],"subject":[],"published":{"date-parts":[[2015,11,10]]}}}