RESISTANT ARTERIAL HYPERTENSION: PHARMACOLOGICAL AND NON-PHARMACOLOGICAL STRATEGIES IN CLINICAL MANAGEMENT

Abstract

Introduction: Resistant arterial hypertension (RAH) is characterized by persistently elevated blood pressure despite the use of three antihypertensive medications, one of which is a thiazide diuretic. Causes such as primary aldosteronism can be effectively treated with precise diagnosis. Strategies include pharmacological treatments, lifestyle modifications, and technological innovations. Methodology: A qualitative bibliographic review was conducted using the PubMed, SciELO, and Google Scholar databases, employing DeCS and MeSH descriptors. Articles published between 2018 and 2024 focusing on the clinical management of resistant arterial hypertension were included. After an initial analysis of 5,234 articles, 8 were selected based on inclusion and exclusion criteria. Results and Discussion: The review revealed that RAH is a prevalent and challenging condition associated with high cardiovascular risks and target organ complications. Studies emphasize the need for personalized approaches integrating pharmacological interventions, such as mineralocorticoid receptor antagonists, and lifestyle changes. The literature highlights that emerging strategies, including innovative technologies and specific therapies for high-risk populations, have shown potential to improve clinical management and cardiovascular outcomes. Conclusion: The review emphasized that RAH is a complex condition requiring pharmacological interventions, lifestyle changes, and emerging technologies. Vulnerable populations, such as Afro-descendants and dialysis patients, require tailored strategies to mitigate cardiovascular risks. An integrated and multidisciplinary approach is essential to optimize management and improve outcomes.