• Pressão arterial acima de 140/90 mmHg de forma persistente
• Uso de três medicamentos anti-hipertensivos diferentes, sendo um deles obrigatoriamente um diurético, em doses adequadas
• Ou necessidade de quatro ou mais medicamentos para manter a pressão controlada

Vários fatores podem estar por trás da hipertensão resistente:

1. Causas secundárias
   • Doenças renais (como estenose de artéria renal, doença renal crônica)
   • Alterações hormonais (hiperaldosteronismo, feocromocitoma, síndrome de Cushing)
   • Apneia obstrutiva do sono
2. Hábitos de vida
   • Consumo excessivo de sal
   • Uso de anti-inflamatórios ou corticoides
   • Ingestão frequente de álcool
3. Adesão ao tratamento
   • Esquecimento de doses
   • Suspensão por conta própria
   • Uso incorreto dos medicamentos
4. Padrão noturno alterado
   • Pressão que não cai à noite ou que até aumenta durante o sono – identificada pelo exame MAPA

Muitas vezes não há sintomas claros, mas podem surgir:

• Dor de cabeça matinal
• Tontura
• Cansaço
• Falta de ar
• Inchaço nas pernas (em casos de problema renal ou cardíaco associado)

Além das medidas de pressão em consultório, é essencial:

• MAPA 24h – para avaliar o comportamento da pressão ao longo do dia e noite
• Exames de sangue e urina – para investigar causas renais ou hormonais
• Estudos do sono – para detectar apneia

O tratamento é individualizado e pode incluir:

• Ajuste de doses e combinações de medicamentos
• Investigação e tratamento de causas secundárias
• Redução do consumo de sal
• Controle de peso e prática de atividade física
• Tratamento da apneia do sono
• Orientação para melhorar a adesão ao tratamento

1. É possível controlar a hipertensão resistente?
   Sim. Na maioria dos casos, identificando e tratando a causa, é possível atingir a meta de pressão.
2. Preciso de mais medicamentos?
   Nem sempre. Muitas vezes, mudar a combinação ou corrigir hábitos de vida já melhora o controle.
3. A hipertensão resistente é mais perigosa?
   Sim. Ela aumenta o risco de AVC, infarto e doença renal crônica, por isso deve ser tratada rapidamente.

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data-elementor-inline-editing-toolbar=\”advanced\”>\n\t\t\t\t<h4><span style=\”font-weight: 400;\”>Com ampla experiência no diagnóstico e tratamento de hipertensão resistente, realizo investigação completa e desenvolvo um plano terapêutico adaptado a cada paciente, visando proteger o coração, o cérebro e os rins.</span></h4><h4><b>Agende uma consulta</b><span style=\”font-weight: 400;\”> para entender por que sua pressão não controla e receber um tratamento eficaz e seguro.</span></h4>\t\t\t\t\t</div>\n\t\t\t\t\t\t\t\t</div>\n\t\t”}]}

• Se a pressão não baixa mesmo com três ou mais medicamentos
• Se a pressão sobe à noite ou de madrugada
• Se tem sintomas persistentes ou exames alterados