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Wednesday 3 December 2014

Why Diagnosis of Treatment Resistant Hypertension is Important?

It is a well known fact that heart diseases have been claiming the lives of people more than any other disease. Termed as Coronary Heart Disease, this cardiac condition leads to heart attack, stroke and other major cardiovascular events. Treatment of coronary heart disease mainly focuses on controlling the risk factors by making lifestyle changes and prescribing drug treatments. High blood pressure (hypertension) and high blood cholesterol levels are the biggest risk factors that need to be brought under control. Several studies, clinical trials and research findings have stated that patients with resistant hypertension are even at higher risk of cardiovascular morbidity, stroke and mortality. Treatment resistant hypertension is a medical condition when the blood pressure remains stubbornly above the target in spite of the use of a diuretic and at least two other medications; patients whose blood pressure is controlled by four or more medications can be termed as resistant to treatment.

Accurate diagnosis and effective use of multiple drug regimens is significant in order to tackle treatment resistant hypertension. The goal blood pressure is less than 140/90 mmHg and achieving this level is even more important among resistant hypertension patients as it is associated with worse cardiovascular events. Taking accurate measurements of blood flow blood pressure is substantial for confirming treatment resistance. Direct (invasive) and indirect (non-invasive) methods are available for measuring the blood pressure and blood flow. Direct method involves using intra-arterial catheter to puncture a blood vessel and taking measurements directly, whereas the non-invasive method is about measuring the arterial pressure indirectly with a manual sphygmomanometer or an automated oscillometric device.

Physicians often prefer the indirect method because it’s the ‘gold standard’ method for routine measurements and monitoring. However, the accuracy levels of indirect measurements are low when compared to the direct methods. That is why it is important to have a hemodynamic monitoring system especially during the invasive procedures. Xper Flex Cardio physiomonitoring system introduced by Philips Healthcare is an innovative step towards this direction. It not only displays the invasive blood pressure blood flow, but also Fractional Flow Reserve measurements, ECG, respiration and other vital signs. Xper Flex Cardio systems prove to be of great use in areas where hemodynamic cardiac monitoring is required. To return to the subject of treatment resistant hypertension, we can say that ruling out the pseudoresistance factors and identification of the true causes can help in devising an effective prevention and management strategy of this condition.