This book is designed to assist physicians in the everyday management of hypertensive patients, with a particular focus on difficult-to-treat and resistant hypertension. The selected clinical cases are representative of the patients who are seen in the "real world", rather than rare clinical cases, and provide examples of management according to current international guidelines. The scenarios considered include not only cases in which arterial hypertension is truly resistant but also instances of pseudo-resistant hypertension, including cases in which resistance is related to comorbidities, concomitant treatments, or the use of drugs. The ultimate objective is to provide paradigmatic examples of evidence-based approaches to difficult-to-treat patients that will help physicians to select the most appropriate diagnostic tools and evidence-based treatment strategy for each individual patient.
Massimo Salvetti is Associate Professor of Internal Medicine at the Department of Medical and Surgical Sciences, University of Brescia, Italy. Since 1990 Dr. Salvetti is involved in research activity in various topics: the role of the sympathetic nervous system and of the renin-angiotensin-aldosterone system in the pathogenesis of essential hypertension, angina pectoris and heart failure; the pathophysiology of cardiac hypertrophy in essential hypertension; the interrelationships between cardiac and vascular changes and their regression after treatment; the noninvasive evaluation of endothelial function, arterial atherosclerosis and arterial stiffness in low and high risk subjects. He is author of more than 140 papers and he is member of different study groups, among which the "Micro and macrocirculation" group of the European Society of Cardiology.
Clinical scenario 1: Adult Patient with True Resistant Hypertension.- Clinical scenario 2: Adult Patient with Pseudo-Resistant Hypertension: high BP induced by exogenous substances.- Clinical scenario 3: Adult Patient with Pseudo-Resistant Hypertension: low adherence.- Clinical scenario 4: Adult Patient with Pseudo-Resistant Hypertension: drug intolerance.- Clinical scenario 5: Adult Patient with Pseudo-Resistant Hypertension: spurious resistant hypertension.- Clinical scenario 6: Adult Patient with Pseudo-Resistant Hypertension: comorbidities.