Resistant hypertension: evaluation of the patient.

Resistant hypertension is a common and serious problem. Before major changes in management are undertaken, seven questions should be asked: 1. What is a realistic goal blood pressure? 2. Is the erect blood pressure below the goal? 3. Is the patient compliant? 4. Does the patient have `office hypertension'? 5. Is the patient using medication which aggravates hypertension? 6. Are there confounding renal or cardiovascular responses to medication? 7. Has a secondary cause of hypertension been overlooked? Newer and more potent medications such as captopril and minoxidil should be recommended only after exploration of these questions and after careful clinical and laboratory evaluation.