Executive summaries on hypertension III. Managing difficult-to-treat hypertension

Hypertension may be difficult to treat for multiple reasons. First some patients have pseudoresistance, displaying high pressure readings only in the physician's office from the 'white coat' effect. Second, volume expansion, usually from inadequate diuretic therapy, is the most common reason for true resistance. A number of other mechanisms may be involved, which can usually be ascertained and overcome.