We've heard about drug-resistant bugs, but drug-resistant hypertension is likely a greater risk to Americans--and the pharmaceutical industry has its work cut out for it on this one. About 1.5 billion people around the globe have high blood pressure, or hypertension, including about one-third of those in America, where it is the most commonly diagnosed condition. There are many drugs on the market to treat high blood pressure, as well as a variety of multi-drug regimens, yet about two-thirds of Americans with hypertension do not have it under control. HTN is a major contributor to morbidity and mortality in the U.S.
It is true that many patients do not take their medications properly--or at all. Hypertension, sometimes called the "silent killer" is often asymptomatic, leading patients to believe they are just fine, but high blood pressure is a major cause of strokes, heart attacks and heart failure, and kidney disease.
However, about a quarter of patients have "resistant hypertension"--defined as a lack of clinical control of blood pressure despite being on three or more medications--although they do take their medications properly, according to an expert panel that the American Heart Association assembled. These patients simply have no success, even when taking multiple drugs. Additionally, studying these individuals is complex, as many take multiple medications and have a few or several concomitant medical problems.
According to the AHA, hypertension incidence and prevalence will continue to rise in America, as obesity rates rise and the elder population grows. Other risk factors are a high-sodium diet, sleep apnea and chronic kidney disease--as well as living in the Southeast. Non-drug alternatives--such as lifestyle changes and Web monitoring by a pharmacist--are having some successes for hypertension control and medication compliance.