MANEJO DA HIPERTENSÃO ARTERIAL RESISTENTE: UMA REVISÃO INTEGRATIVA DE LITERATURA

ABSTRACT Introduction: Resistant arterial hypertension (RAH) is defined as the persistence of blood pressure levels above the individual target, despite the concomitant use of three classes of antihypertensive drugs at optimized doses, including a diuretic, or the use of four or more drugs. It is a condition associated with a high risk of cardiovascular and renal events, requiring specific and up-to-date therapeutic strategies. This literature review aimed to identify and analyze the most effective pharmacological approaches currently recommended for the management of ARH, as well as to discuss emerging therapies under investigation. Methods: A narrative search was carried out in scientific databases such as PubMed, Scielo and Google Scholar, using descriptors related to resistant hypertension and its treatment. Articles in English and Portuguese were included, focusing on clinical guidelines, controlled trials and relevant meta-analyses. Results: 320 articles were found. After removing duplicates, 180 papers remained. After screening the titles and abstracts of the studies, 19 papers were selected to be read in full, of which 5 were selected for this review. Conclusion: The findings indicate that initial treatment should include a combination of an ACEI or ARB, a calcium channel blocker and a thiazide or similar long-acting diuretic. When necessary, the addition of a mineralocorticoid receptor antagonist Key words: Hypertension, Resistant; Treatment; Management.