True versus pseudoresistant hypertension
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. 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.