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Current hypertension guidelines recommend a thiazide diuretic, a calcium-channel blocker, and an angiotensin-converting enzyme inhibitor or an angiotensin-receptor blocker, singly or in combination, to achieve target blood pressure (BP). Resistant hypertension — defined as uncontrolled BP despite treatment with medications from all three classes — is estimated to occur in at least 10% of treated hypertensive patients and carries excess risk for adverse cardiovascular outcomes. In a 2015 meta-analysis, researchers found that aldosterone antagonists were safe and effective for patients with resistant hypertension (Am J Hypertens 2015; 28:1376), but little is known about the comparative effectiveness of other potential treatments.
Researchers i…