O diagnóstico acurado de hipertensão arterial resistente na melhora do prognóstico cardiovascular: uma revisão sistemática de literatura

Abstract

INTRODUCTION: Resistant arterial hypertension has been considered an important risk factor for the development of cardiovascular diseases. As a result, several studies seek to systematize therapeutic measures to reduce the burden of resistant hypertensive patients. In this sense, the scientific literature in the area highlights that the diagnosis has been instrumental in improving the prognosis of these patients, since there are external conditions that influence the increase in blood pressure and contribute to the conclusion of a false diagnosis of resistant arterial hypertension. PROBLEMATIZATION: Therefore, the question is: to what extent can the accurate diagnosis of Resistant Arterial Hypertension (RAH) improve the cardiovascular prognosis? What factors influence the diagnosis of Resistant Arterial Hypertension? What measures should be taken for an accurate assessment of Resistant Arterial Hypertension? OBJECTIVE: For all of the above, this research aims to analyze how the accurate diagnosis of Resistant Arterial Hypertension (RAH) can improve cardiovascular prognosis. METHODOLOGY: The research is conducted methodologically by the principles of systematic literature review. RESULTS AND DISCUSSIONS: 19 studies were found, through a systematic literature review, seeking to map clinical conditions that interfere in the diagnosis of resistant hypertension, such as Pseudoresistance; effect of the white coat and secondary causes. The scientific literature points out that it is necessary to systematically assess such external conditions of elevated Blood Pressure, excluding them when necessary to effectively conclude the accurate diagnosis of resistant hypertension. Thus, it is observed that the effective management of resistant hypertension requires, firstly, a careful examination and exclusion of the factors associated with Pseudoresistance and, secondly, the identification and, when possible, the modification of the factors related to the true elevations of the Pressure Arterial. After these factors are successfully managed, an aggressive treatment regimen designed to compensate for all mechanisms of elevating blood pressure should be promoted and, consequently, moving towards effective blood pressure control for most patients. FINISH CONSIDERATIONS: Therefore, in terms of conclusion, the research corroborates with the literature in that it points to the accurate diagnosis as a determinant for the improvement of the cardiovascular prognosis of the patient with resistant hypertension.