Resistant Hypertension

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You take your fair share of medications, but your stubborn blood pressure is still too high. Nothing is working. Now what?

You might have resistant hypertension, which means your blood pressure is hard to manage. And that’s completely frustrating because what should work doesn’t. And the longer your blood pressure hovers at the top of the charts, the more you’re at risk for heart attacks, strokes and other health problems, like kidney disease.

The experts at Cleveland Clinic understand how exasperating and scary it can be when your blood pressure just won’t go down no matter what you do. They’re here to help you get things in check, so you can relax and stop worrying about the “what ifs.”

Why Choose Cleveland Clinic for Resistant Hypertension Care?

Trusted experts:

People travel to Cleveland Clinic from all over the U.S. and around the world to be treated for all types of hypertension, including resistant hypertension.

Patient-centered care:

Even if you had treatment elsewhere, we start back at the beginning to make sure we don’t miss anything when diagnosing your resistant hypertension. We talk with you, examine you and check your blood pressure to develop the best treatment plan.

Recognized expertise:

The American Heart Association has named Cleveland Clinic one of the nation’s top hospitals for experience and excellent care managing difficult hypertension conditions. Meet our team.

Innovation and research:

We’re always looking for new ways to lower high blood pressure and treat resistant hypertension. Our healthcare providers lead and participate in clinical trials to study new blood pressure medications and treatments.

Specialized knowledge:

Cleveland Clinic experts keep an eye on your blood pressure virtually with special computer programs. We track how your blood pressure changes throughout the day for the most accurate diagnosis.

Virtual visits:

If you’re a new patient in Ohio, you can start your preventive cardiology care with a virtual visit — and keep on scheduling them when you need to. If you live in another state, you’ll need an in-person visit first. Then, you’re welcome to schedule virtual appointments at any time, from anywhere.

National recognition:

Cleveland Clinic is a trusted healthcare leader. We're recognized in the U.S. and throughout the world for our expertise and care.

Resistant Hypertension Diagnosis at Cleveland Clinic

Managing resistant hypertension begins with making sure that’s exactly what you have. We’ll start by asking about your symptoms and how long you’ve had them. We’ll want to know what medications you’re taking and if you’re taking them the right way. And we’ll do a physical exam.

If you have test results from another provider, our specialists will take a look at those, too. Then, we’ll do our own testing to check things out. We may:

Do blood tests to see how much sugar (glucose), sodium and potassium is in your blood.
Do urine (pee) tests to look for protein, which can make your blood pressure go up.
Talk about your diet and exercise habits.
Do imaging tests, like X-rays, ultrasound and CT scans, to rule out other conditions that could be causing your resistant hypertension.
Do tests to check for kidney disease, narrowing of your arteries or problems with your adrenal gland.
Test you for thyroid disease because issues with your thyroid (hypothyroidism) can lead to high blood pressure.
Recommend you take part in a sleep study to check for sleep apnea, which can lead to resistant hypertension.

Your Resistant Hypertension Care Team

Your care doesn’t happen in a vacuum. There are many healthcare providers you might meet throughout your journey, including:

Cardiologists (heart specialists).
Nephrologists (kidney specialists).
Endocrinologists (hormone specialists).
Vascular medicine specialists (providers who treat blood vessels).

Providers Who Treat Resistant Hypertension

Locations

Our healthcare providers see patients at convenient locations throughout Northeast Ohio, Florida and London.

Resistant Hypertension Treatment at Cleveland Clinic

Once we know more about your blood pressure, we can design a personalized treatment plan for you.

Continued blood pressure monitoring

We may ask you to keep track of your blood pressure and report readings. You’ll wear an inflatable cuff that attaches to a small device. The cuff inflates about every half hour, and the device records your blood pressure.

Our experts may also recommend remote blood pressure monitoring for a month or so. You purchase a device that automatically uploads blood pressure readings to your electronic medical record. This allows your providers to see how your resistant hypertension treatment is working.

If you’re anxious when you visit your provider, your blood pressure may be higher in the office (white coat syndrome). We may recommend 24-hour ambulatory blood pressure monitoring to see how your blood pressure changes at home, including while you’re sleeping.

Lifestyle changes

Our specialists may suggest you work with other Cleveland Clinic experts, like dietitians and exercise physiologists, who can help you make lifestyle changes, such as:

Eating a healthy low-fat, low-salt diet.
Not drinking too much alcohol.
Getting regular exercise.
Not smoking.
Reducing stress and managing your weight.
Using Tylenol® instead of Advil® or Motrin® for pain.

Medications

Often, resistant hypertension happens when medications aren’t taken the right way. For them to work, you must take the correct dose for the correct number of times every day. If you’re having side effects from your medications that keep you from taking them the right way, let us know. We may be able to switch one medication for another that won’t bother you as much or that you don’t have to take as often. Don’t stop taking any medications until you talk with your provider.

Taking the Next Step

If you have stubborn high blood that just won’t cooperate with medications — no matter how many you try — it’s important to see your healthcare provider right away. Resistant hypertension can lead to many other health issues, like heart attacks, stroke and kidney disease. Cleveland Clinic experts can help you manage your blood pressure so you can check that worry off your list.