{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T17:33:23Z","timestamp":1785432803753,"version":"3.56.0"},"reference-count":74,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2023,4,20]],"date-time":"2023-04-20T00:00:00Z","timestamp":1681948800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Ministry of Education, Science and Technological Development of the Republic of Serbia","award":["451-03-9\/2021-14\/200113"],"award-info":[{"award-number":["451-03-9\/2021-14\/200113"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>With the medical and social importance of resistant arterial hypertension (HTN) in mind, we had three goals in this paper: to study the definitions of resistant HTN in the guidelines on the topic, to analyze them, and to suggest some improvements. We found (at least) eleven insufficiencies in the definition of resistant HTN: (1) different blood pressure (BP) values are used for diagnoses; (2) the number of BP measurements is not specified; (3) the time-frame for the definition is not obtained; (4) it fails to provide normal or target or controlled BP values; (5) secondary HTN is not currently defined as true resistant HTN, but as apparently treatment-resistant HTN; (6) the definition usually directly incorporates BP cut-offs for systolic BP (sBP) and diastolic BP (dBP) making the diagnosis temporary; (7) stress is not included in the exclusion strategy for resistant HTN; (8) there is potentially a need to introduce a category of recovered resistant HTN; (9) to what degree do healthy lifestyle measures have to be fulfilled to consider it as sufficient to change the diagnosis from \u201capparent treatment-resistant HTN\u201d to the \u201cresistant HTN\u201d; (10) sBP values normal-for-the-age for 61 and 81 year old patients in some guidelines fulfill the criterion for resistant HTN; (11) it probably ought to read \u201cIn the absence of contraindications and compelling indications\u2026\u201d in the others. We believe that it is better to use the phrase \u201cabove the target BP\u201d for the definition of (treatment) resistant HTN, because the whole story of resistant HTN is related to non-responders to antihypertensive treatment. Therefore, as we treat to target and not to normal values, it is appropriate to define resistant HTN as an insufficiency to reach the target BP values. Moreover, the definition of (treatment) resistant HTN should not be universal for every patient with HTN, but it should be age-related: (treatment) resistant HTN is elevated BP over the target\/normal BP values. Using this modification, there will be no need to automatically change the definition of resistant HTN when we change the BP targets in the future.<\/jats:p>","DOI":"10.3390\/medicina59040803","type":"journal-article","created":{"date-parts":[[2023,4,20]],"date-time":"2023-04-20T05:35:46Z","timestamp":1681968946000},"page":"803","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["A Need for Improvement in the Definition of Resistant Arterial Hypertension"],"prefix":"10.3390","volume":"59","author":[{"given":"Goran","family":"Koracevic","sequence":"first","affiliation":[{"name":"Department for Cardiovascular Diseases, Clinical Center Nis, 18000 Nis, Serbia"},{"name":"Faculty of Medicine, University of Nis, 18000 Nis, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sladjana","family":"Micic","sequence":"additional","affiliation":[{"name":"Clinic for Nephrology, University Clinical Center Nis, 18000 Nis, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Milovan","family":"Stojanovic","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Nis, 18000 Nis, Serbia"},{"name":"Institute for Treatment and Rehabilitation Niska Banja, 18000 Nis, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marija","family":"Zdravkovic","sequence":"additional","affiliation":[{"name":"University Hospital Medical Center Bezanijska Kosa, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,4,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1334","DOI":"10.1161\/HYPERTENSIONAHA.120.15026","article-title":"2020 International Society of Hypertension Global Hypertension Practice Guidelines","volume":"75","author":"Unger","year":"2020","journal-title":"Hypertension"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1007\/s11906-022-01173-w","article-title":"The Burden of Resistant Hypertension Across the World","volume":"24","author":"Brant","year":"2022","journal-title":"Curr. 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