Background
Definition and prevalence of RHT
Pseudoresistance
Prognosis and clinical importance of accurate RHT diagnosis
Diagnostic approach of resistant hypertension
Characteristics of out-of-office BP measurements for diagnosis of RHT
Characteristic | Clinic BP | Ambulatory BP | Home BP |
---|---|---|---|
No. of measurements | Low | High | High |
Reliability | Low | Medium | High |
Repeatability | High | Low | High |
Standardization | Low | High | Low |
Device validation | High | High | Variable |
Reflection of prognosis | Weak | Adequate | Adequate |
White-coat effect | Not available | Available | Available |
Masked hypertension | Not available | Available | Available |
Nocturnal hypertension | Not available | Available | Possibly available |
Morning surge | Not available | Available | Possibly available |
Self-monitoring | No | No | Yes |
Drug adherence | No effect | No effect | Improving |
Telehealth | Not available | Not available | Available |
Procedure | Recommendation |
---|---|
Precaution | No tobacco or caffeine consumption, or heavy exercise 30 min before measurement After voiding Use of an upper arm cuff Place the arm at heart level, with supported back and feet flat on the ground After 2–5 min of rest |
Time | Morning: within 1 h after waking up, before taking antihypertensive drugs, and before breakfast Night: before bedtime Before taking a shower/bath |
Schedule and frequency | 7-Day measurements, 2–3 times per session Diagnosis: ≥1 wk Follow-up treatment: 5–7 day preceding the clinic visit |