Resistant Hypertension

Hypertension is the medical term for high blood pressure that does not respond to treatment.  Hypertension can cause moderate and severe vascular damage.  In order to understand this damage, however, it is first necessary to understand what healthy arteries and veins look like.  In general, healthy arteries and veins have smooth inner linings that allow blood to flow freely. Healthy veins and arteries also are strong and flexible. 

Patients with hypertension, however, can potentially have veins and arteries with a variety of issues.  The most common is artery damage and narrowing. Hypertension can damage the cells of the arteries’ inner lining, launching a cascade of events that make the artery walls thick and stiff.  This disease is called arteriosclerosis. As fats from the patient’s diet enter his or her bloodstream, they will pass through the damaged cells and collect into clumps.  This can change arteries throughout the body, blocking blood flow to the heart, kidneys, brain, and extremities. These blockages can cause many problems, including chest pain, heart attack, heart failure, kidney failure, stroke, blocked arteries in the legs or arms, eye damage, and aneurysms.

Unfortunately, these blockages are not the only concerning effect of hypertension.  Over time, the constant higher pressure of blood moving through any weakened artery can cause a section of the artery’s wall to enlarge and form a bulge.  This bulge or enlargement is known as an aneurysm.  These areas can rupture and cause life-threatening internal bleeding. Aneurysms can form in any artery throughout the body, but they’re most commonly found in the aorta.

Additionally, diseases such as coronary artery disease that affect the arteries which supply blood to the heart can be worsened with a condition such as hypertension.  Arteries that have become narrow from coronary artery disease don’t allow blood to flow freely. When blood can no longer flow freely to the heart a patient can experience chest pain, heart attack or irregular heart rhythms.

In addition, there are a number of effects that hypertension has on the heart itself.  Hypertension forces the heart to work harder than necessary in order to pump blood to the rest of the body. This causes the left ventricle to thicken or stiffen, creating a condition known as an enlarged left heart. This condition increases the patient’s risk of heart attack, heart failure and sudden cardiac death.