Resistant Hypertension: Causes, Symptoms, Treatment and Diagnosis


Medically reviewed by

Bajaj Finserv Health


5 min read


Resistant hypertension refers to high blood pressure levels despite taking medications. Be aware of resistant hypertension causes like pain killer pills and get resistant hypertension treatment.

Key Takeaways

  • Resistant hypertension is more prevalent in the older population as per studies
  • Having birth control pills may be one of the resistant hypertension causes
  • Resistant hypertension treatment includes modifying your existing lifestyle

High blood pressure is also called hypertension. When it is difficult to control your high blood pressure despite taking medications, you’re experiencing a condition known as resistant hypertension. Your doctor may have prescribed two or more medicines to reduce your blood pressure. However, you may not find any improvement in lowering your blood pressure even after taking them. In this, your blood pressure reading remains at 130/80mmHg even if you are on two blood pressure medications and one water pill.

If you delay resistant hypertension treatment, it may lead to heart failure, kidney disease, or even stroke. People with it are more prone to these ailments rather than those with controlled blood pressure levels. Interestingly, a study revealed that the incidence of resistant hypertension is high in those who have chronic kidney disease [1].

While you may find different types of hypertension prevalence in India, not many studies have been conducted on its prevalence. However, facts reveal that the incidence of resistant hypertension is more among women and the geriatric population in India [2]. 

What you need to be aware of is that if your blood pressure continues to spike out of control, it may lead to malignant hypertension. In this condition, there is a sudden rise in your blood pressure, which may affect the functioning of your vital organs. When there is an increase in your blood pressure levels due to narrow arteries that transport blood to your kidneys, it may result in a condition called renal hypertension

So, it is important to keep a close watch on your blood pressure levels for good health. For detailed insight on resistant hypertension causes, treatment, and symptoms, read on.

Additional read: Malignant Hypertension Causeshypertension complications

Resistant Hypertension Causes 

Lifestyle patterns and diet are a few important causes. If you are eating foods high in salt or leading an inactive lifestyle, you may be prone to both hypertension and resistant hypertension. Excessive consumption of alcohol and obesity are a few other contributing factors to this condition. Apart from these, intake of the following medications can also cause resistant hypertension.  

  • Birth control pills 
  • Painkillers 
  • Licorice 
  • Decongestants for nose 

While these are the main resistant hypertension causes, remember not to ignore the secondary causes either. By treating these secondary causes, you may be able to avoid resistant hypertension [3]. 

  • Chronic kidney disease 
  • Sleep apnea 
  • Narrowed arteries of the kidney 
  • Problems with thyroid functioning 

Resistant Hypertension Symptoms 

You may have hypertension, but you may not realize it for years due to the absence of symptoms. However, if you do not check your blood pressure regularly and get the necessary treatment, it can even prove fatal. It is advisable to get a BP monitor at home to regularly check your blood pressure as you age.

In the stage of hypertensive crisis, which is the most life-threatening stage, you may experience the following symptoms. 

  • Severe pounding in the chest 
  • Fatigue 
  • Dizziness 
  • Inability to breathe properly 
  • Persistent headaches 

This stage requires immediate medical intervention. Proper monitoring of blood pressure can prevent resistant hypertension. 

Resistant Hypertension Diagnosis 

To diagnose resistant hypertension, you may have to undergo a physical examination. Your doctor may also enquire about your previous medical history, followed by checking your blood pressure levels. In some cases, you may have to undergo tests to assess if you are prone to any secondary conditions like chronic kidney disease and so on.

Provide a detailed list of all medications you are taking to your doctor. During the physical examination, your doctor may also check for any unusual changes in your eyes. A few laboratory tests which you have to undergo include: 

  • Thyroid function tests 
  • Adrenal hormone tests 
  • Glucose test 
  • Blood tests to check creatinine, potassium, and sodium levels 
  • Urine test to check albumin levels 

The following imaging tests are required to check if there is any organ damage due to resistant hypertension. 

  • X-ray of your chest 
  • Electrocardiogram 
  • ECG 
  • Eye examination using fundoscopy 
  • CT scan 

Resistant Hypertension

Resistant Hypertension Treatment 

While you may be familiar with resistant hypertension symptoms and causes, it is vital for you to be aware of the treatment plan for this condition. Depending on your response to blood pressure medications and your existing hypertension conditions, your doctor may devise a resistant hypertension treatment plan for you.  

By slightly modifying your existing lifestyle patterns, you may be able to prevent resistant hypertension. Follow these simple home remedies and keep your blood pressure levels at bay. 

  • Consume a healthy and nutritious diet 
  • Exercise regularly daily 
  • Minimize the intake of sodium in your diet 
  • Avoid smoking 
  • Reduce the consumption of alcohol 
  • Practice meditation to reduce stress 
  • Maintain your BMI levels 
  • Monitor your BP regularly 
  • Visit a doctor when required 
  • Manage sleep apnea by adopting PAP (positive airway pressure) therapy 

In some cases, resistant hypertension treatment remains unsuccessful because of an incorrect way of taking medications. It is important to consume the right dosage at proper intervals for treating it. Talk to your doctor if you are unable to follow the dosage properly.

Additional read: How to Manage Hypertension

Now that you are aware of it take care to monitor your BP levels regularly. Lead an active lifestyle and limit the consumption of processed foods as these are high in salt and have little to zero nutritional value. If you are experiencing symptoms like chest pain or dizziness, connect with top physicians on Bajaj Finserv Health. Get a doctor consultation either in-person or online and address all your hypertension symptoms. Follow proper nutritional advice given by doctors and keep your blood pressure levels in control.

Published on 16 Jun 2022Last updated on 10 Dec 2022

Please note that this article is solely meant for informational purposes and Bajaj Finserv Health Limited (“BFHL”) does not shoulder any responsibility of the views/advice/information expressed/given by the writer/reviewer/originator. This article should not be considered as a substitute for any medical advice, diagnosis or treatment. Always consult with your trusted physician/qualified healthcare professional to evaluate your medical condition. The above article has been reviewed by a qualified doctor and BFHL is not responsible for any damages for any information or services provided by any third party.


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