Resistant Hypertension: What You Need to Know

If your doctor says you have "resistant hypertension," it means your blood pressure stays above the target even after taking three different medicines, including a diuretic. It can feel frustrating, but knowing the reasons and what works helps you take control.

Why Blood Pressure Stays High

First, check if you’re actually taking the meds correctly – missing doses or stopping early is more common than you think. Some drugs interact with each other or with foods (like salty meals or grapefruit) and make them less effective.

Second, hidden health issues can raise pressure without obvious signs. Sleep apnea, kidney disease, hormone problems such as hyperaldosteronism, and chronic stress all push numbers up. A quick sleep study or blood test often uncovers the culprit.

Third, lifestyle habits matter a lot. Too much sodium, low potassium, excess alcohol, and lack of exercise create a perfect storm for stubborn high pressure.

Practical Steps to Lower It

Start with your medication list. Ask your doctor if adding or swapping a drug like spironolactone (a potassium‑sparing diuretic) could help. Some patients benefit from a low‑dose mineralocorticoid blocker even when other meds fail.

Next, tackle sleep apnea. A simple home test can point you toward a CPAP machine – many people see their numbers drop by 10‑15 mmHg once they start using it nightly.

Adjust your diet: aim for less than 1,500 mg of sodium per day (that’s about one teaspoon of salt). Load up on potassium‑rich foods like bananas, spinach, and beans; they naturally counteract sodium’s effect.

Exercise doesn’t have to be a marathon. A brisk 30‑minute walk most days, or a short home routine with body‑weight squats and jumping jacks, can lower pressure by a few points over weeks.

Limit alcohol to two drinks a day for men and one for women. Even moderate drinking adds up and can keep your BP high.

Stress management is often overlooked. Try simple breathing exercises – inhale for four seconds, hold for seven, exhale for eight – a few times before bed. Many users report calmer mornings and lower readings.

Finally, keep track. Use a home cuff that’s validated (look for the AHA logo) and write down your numbers each morning. Spotting patterns helps you and your doctor fine‑tune treatment faster.

Resistant hypertension isn’t a dead end. With the right med tweaks, sleep checks, diet tweaks, movement, and stress hacks, most people see measurable improvement within a few months.