Treatment of Refractory Hypertension

    April 1982 in “ Lancet ”
    J. D. Swales, AM Heagerty, G. I. Russell, R. F. Bing, Jürgen Pohl, H. Thurston
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    TLDR Most patients with hard-to-treat high blood pressure can be managed effectively with various treatments, but no single treatment is perfect.
    In a study from 1982 involving 126 patients with hypertension resistant to conventional treatment, various regimens were assessed, including oral diazoxide, minoxidil, captopril, and quadruple therapy. The study found that blood pressure could be controlled in nearly all patients, with no deaths from cerebrovascular disease during treatment. However, 2 patients died from renal failure, 5 required long-term haemodialysis, and ischaemic heart disease caused 10 deaths. Diazoxide was the most effective in controlling blood pressure but was also the most difficult and unpleasant to use. Captopril was well-tolerated but failed in 6 out of 15 patients. The study concluded that while no treatment is perfect, there are now enough alternatives to manage blood pressure in patients with refractory hypertension effectively.
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