Gifford R W, Tarazi R C
Ann Intern Med. 1978 May;88(5):661-5. doi: 10.7326/0003-4819-88-5-661.
Fortunately, hypertension resistant to a good drug regimen is rare. When hypertension fails to respond to medical treatment there is usually another explanation, such as poor patient compliance, excessive salt ingestion, drug interactions, spuriously high office readings, or an unsuspected secondary cause for the hypertension. Management of resistant hypertension can be aided by identifying the hemodynamic and humoral mechanisms responsible for its resistance and redesigning the therapeutic regimens accordingly. When they become available, two investigational drugs, minoxidil and an oral converting enzyme inhibitor, both of which lower total peripheral resistance, will offer a new approach to controlling truly resistant hypertension.
幸运的是，对良好药物治疗方案耐药的高血压很少见。当高血压对药物治疗无反应时，通常有其他原因，如患者依从性差、盐摄入过多、药物相互作用、诊室测量值假性升高或未被怀疑的高血压继发原因。通过识别导致耐药的血流动力学和体液机制并相应地重新设计治疗方案，有助于管理难治性高血压。当两种研究性药物（米诺地尔和一种口服转换酶抑制剂，二者均可降低总外周阻力）可用时，将为控制真正难治性高血压提供一种新方法。
