Algorithm for the management of resistant hypertension from JAMA. Key steps: Patient presents with apparent resistant hypertension (HTN); Screening for white-coat effect (WCE); Assessment of medication adherence; Screening for secondary causes of HTN; Confirmation of true resistant HTN; Treatment.

#ResistantHypertension affects approximately 10% of patients treated for #hypertension and is associated with increased #cardiovascular mortality compared with controlled blood pressure.

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Spironolactone vs Amiloride for Resistant Hypertension This randomized trial assesses whether amiloride is noninferior to spironolactone in reducing home-measured systolic blood pressure among patients with resistant hypertension.

【東アジア人治療抵抗性高血圧にはアミロライドも選択肢？
　RCT/ JAMA】

韓国、「ARB・CCB・サイアザイド」４週併用でも「SBP≧130」だった118例 [平均55歳] ランダム化、12週観察：

・アミロライド5 mg/日で家庭SBPは13.6 mmHg低下。スピロ
　ノラクトン 12.5 mg [14.7 mmHg] に非劣性。
・「診察室SBP<130」達成率にも有意差なし。

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#Amiloride #ResistantHypertension