True versus pseudoresistant hypertension

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It is becoming increasingly apparent that uncontrolled resistant hypertension, especially in the primary care setting, is most often attributable to pseudocauses of treatment resistance, including inaccurate blood pressure (BP) measurement, white-coat effect, under treatment, and poor medication adherence. Of these, the latter two are likely the most common. In the current issue of the Journal, Durand et al.[1] provide insight into this important clinical issue by quantifying the range and overall degree of poor medication adherence among patients with resistant hypertension based on a rigorous systematic review and meta-analysis of studies that had reported adherence in patients with resistant hypertension.

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