Factors contributing to resistant hypertension. Cardiac considerations.

Medical treatment of hypertension has beneficial effects in the prevention of complications of the disease and in prolongation of survival. Nevertheless, the control of hypertension may sometimes be difficult. In this respect, the heart itself may interfere with blood pressure control because of increased cardiac output or because of cardiogenic reflexes that could conceivably not only initiate but also perpetuate peripheral vasoconstriction. The resultant persistence of hypertension may induce further cardiac changes that will in turn perpetuate the rise in blood pressure.