In particular, there are a number of high unmet need settings where novel approaches to hypertension are warranted, including resistant and refractory hypertension
, chronic kidney disease, and heart failure.
Currently suggested indications for the procedure include a short duration of severe hypertension, refractory hypertension
uncontrolled by medical therapy, recurrent flash pulmonary oedema with congestive heart failure, and progressively increasing levels of serum creatinine.2
Renovascular hypertension is an unusual but treatable cause of refractory hypertension
that is infrequently caused by compression of the renal vasculature by a giant hydatid cyst.
We report a case of refractory hypertension
accompanied with increased arterial stiffness in a female toddler with NF type 1 and midaortic.
The current guidelines for atherosclerotic RAS recommend PTRA for patients with hemodynamically significant RAS or with the following conditions: flash pulmonary edema, rapidly declining renal function or refractory hypertension
Our patient experienced his first event of refractory hypertension
and angina-like chest pain severe enough to warrant cardiac catheterization following administration of high dose dexamethasone.
Patients with refractory hypertension
should have a reassessment of substance abuse as a potential cause.
Hafeez Chaudhry from Faisalabad discussed optimized medical management of Refractory Hypertension
. He was of the view that if a patient is not responding to two drugs with optimal dose, adds the third drug which should be a diuretic.
Previous studies have shown that increased complexity due to organ perfusion in aortic dissection, aortic rupture, refractory hypertension
, persistent pain, and other factors may increase TBAD mortality (2).
Labetalol infusion for refractory hypertension
causing severe hypotension and bradycardia: an issue of patient safety.
The cardiovascular system of swine has high similarity with human, and swine RDN model does appear to predict security and efficiency the treatment of refractory hypertension
in human subjects.
Direct vasodilators (hydralazine, isosorbide dinitrate) are potent vasodilators that are used to lower BP in patients with resistant or refractory hypertension
(Ram & Fenves, 2009).