Skip to main content

Thank you for visiting You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

Resistant hypertension—complex mix of secondary causes and comorbidities

This is a preview of subscription content

Access options

Buy article

Get time limited or full article access on ReadCube.


All prices are NET prices.


  1. Calhoun DA, Jones D, Textor S, Goff DC, Murphy TP, Toto RD et al. Resistant hypertension: diagnosis, evaluation, and treatment. A scientific statement from the American Heart Association Professional Education Committee of the Council for High Blood Pressure Research. Hypertension 2008; 51 (6): 1403–1419.

    CAS  Article  PubMed  Google Scholar 

  2. Egan BM, Zhao Y, Axon RN, Brzezinski WA, Ferdinand KC . Uncontrolled and apparent treatment resistant hypertension in the United States, 1988–2008. Circulation 2011; 124: 1046–1058.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Roger VL, Go AS, Lloyd-Jones DM, Adams RJ, Berry JD, Brown TM et al. Heart disease and stroke statistics—2011 update: a report from the American Heart Association. Circulation 2011; 123: e18–e209.

    Article  PubMed  Google Scholar 

  4. de la Sierra A, Segura J, Banegas JR, Gorostidi M, de la Cruz JJ, Amario P et al. Clinical features of 8295 patients with resistant hypertension classified on the basis of ambulatory blood pressure monitoring. Hypertension 2011; 57: 898–902.

    CAS  Article  PubMed  Google Scholar 

  5. Daugherty SL, Powers JD, Magid DJ, Tavel HM, Masoudi FA, Margolis KL et al. Incidence and prognosis of resistant hypertension in hypertensive patients. Circulation 2012; 125: 1635–1642.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Florczak E, Szwench E, Śliwiński P, Bieleń P, Klisiewicz A, Michałowska I et al. Clinical characteristics of patients with resistant hypertension. J Human Hypertens 2013; 27 (11): 678–685.

    CAS  Article  Google Scholar 

  7. Logan AG, Perlikowski SM, Mente A, Tisler A, Tkacova R, Niroumand M et al. High prevalence of unrecognized sleep apnea in drug-resistant hypertension. J Hypertens 2001; 19: 2271–2277.

    CAS  Article  PubMed  Google Scholar 

  8. Gonzaga CC, Gaddam KK, Ahmed MI, Pimenta E, Thomas SJ, Harding SM et al. Severity of obstructive sleep apnea is related to aldosterone status in subjects with resistant hypertension. J Clin Sleep Med 2010; 6 (4): 363–368.

    PubMed  PubMed Central  Google Scholar 

  9. Conn JW . Hypertension, the potassium ion and impaired carbohydrate tolerance. N Engl J Med 1965; 273: 1135–1143.

    CAS  Article  PubMed  Google Scholar 

  10. Fallo F, Veglio F, Bertello C, Sonino N, Della Mea P, Ermani M et al. Prevalence and characteristics of the metabolic syndrome in primary aldosteronism. J Clin Endocrinol Metab 2006; 91 (2): 454–459.

    CAS  Article  PubMed  Google Scholar 

  11. Fallo F, Pilon C, Urbanet R . Primary aldosteronism and metabolic syndrome. Horm Metab Res 2012; 44: 208–214.

    CAS  Article  PubMed  Google Scholar 

  12. Ip MS, Lam B, Ng MM, Lam WK, Tsang KW, Lam KS . Obstructive sleep apnea is independently associated with insulin resistance. Am J Respir Crit Care Med 2002; 165: 670–676.

    Article  PubMed  Google Scholar 

  13. Rossi GP, Belfiore A, Bernini G, Fabris B, Caridi G, Ferri C et al. Body mass index predicts plasma aldosterone concentrations in overweight-obese primary hypertensive patients. J Clin Endocrinol Metab 2008; 93: 2566–2571.

    CAS  Article  PubMed  Google Scholar 

  14. Goodfriend TL, Kelley DE, Goodpaster BH, Winters SJ . Visceral obesity and insulin resistance are associated with plasma aldosterone levels in women. Obes Res 1999; 7: 355–362.

    CAS  Article  PubMed  Google Scholar 

  15. Calhoun DA, Sharma K . The role of aldosteronism in causing obesity-related cardiovascular risk. Cardiol Clin 2010; 28 (3): 517–527.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Tuck ML, Sowers J, Dornfeld L, Kledzik G, Maxwell M . The effect of weight reduction on blood pressure, plasma renin activity, and plasma aldosterone levels in obese patients. N Engl J Med 1981; 304: 930–933.

    CAS  Article  PubMed  Google Scholar 

  17. Sim JJ, Yan EH, Liu IL, Rasgon SA, Kalantar-Zadeh K, Calhoun DA et al. Positive relationship of sleep apnea to hyperaldosteronism in an ethnically diverse population. J Hypertens 2011; 29 (8): 1553–1559.

    CAS  Article  PubMed  Google Scholar 

  18. Swatikova A, Olson Lj, Wolk R, Phillips BG, Adachi T, Schwartz GL et al. Obstructive sleep apnea and aldosterone. Sleep 2009; 32: 1589–1592.

    Article  Google Scholar 

Download references


This work was supported by the following grants: RO1-HL79040 and CCTS 5UL1 RR025777.

Author information

Authors and Affiliations


Corresponding author

Correspondence to T Dudenbostel.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Dudenbostel, T. Resistant hypertension—complex mix of secondary causes and comorbidities. J Hum Hypertens 28, 1–2 (2014).

Download citation

  • Published:

  • Issue Date:

  • DOI:


Quick links