Resistant hypertension indicates hypertension that persists despite maximal medical management. Pseudo-resistant hypertension is a situation where the therapy has not been optimized or there is pseudo-hypertension. This is important to identify since management of resistant hypertension may be associated with a number of adverse effects.

Conditions associated with pseudo-resistant hypertension:

(1) pseudohypertension associated with severe atherosclerosis in an artery being used for blood pressure monitoring

(2) pseudohypertension associated white coat hypertension

(3) poor patient compliance with drug therapy

(4) poor technique in blood pressure measurement by the clinician

(5) inadequate dose of antihypertensive medication

(6) inappropriate choice of antihypertensive drugs

(7) failure to educate or to motivate the patient

(8) suboptimal management due to clinical inertia on the part of the clinician

(9) failure to control a condition predisposing to resistant hypertension

(10) failure to refer to a specialist when appropriate

(11) failure to control salt intake

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