High blood pressure ( Hypertension ) is blood pressure that does not show any response to  is called as resistance BP. Particularly, resistant high blood pressure ( Hypertension ) is defined as blood pressure that remains elevated above treatment goals inspite of taking maximum three drugs that includes also a diuretic (Drugs for urine excretion). As it is difficult to treat few cases of high blood pressure ( Hypertension ), and may require a combination of multiple drugs before control is established, high blood pressure ( Hypertension ) cannot be called resistant until this three-drug combination has been tried.

Resistant high blood pressure ( Hypertension ) is diagnosed when the blood pressure continues to be elevated despite trying combination therapy with three drugs. The standard guidelines state that:

    * Proper blood pressure measurement process must be used
    * The size of the blood pressure cuff should be double checked for accuracy
    * The blood pressure readings must be recorded on two separate occasions
       Blood pressure should be taken in sitting and lying position.

There are many factors that can cause resistant high blood pressure ( Hypertension ), and proper medical testing is required to investigate each of these potential causes. The three most common causes of resistant high blood pressure ( Hypertension ) are:

    * Patient is not showing compliance with treatment, i.e not taking medicine regularly.
    * Secondary high blood pressure ( Hypertension ) (Usually from overactive adrenal glands or pheochromocytoma)
    * Fluid retention (usually expansion from kidney failure)

Additionally, it is important to make sure that what appears to be resistant high blood pressure ( Hypertension ) isn’t actually pseudohigh blood pressure ( Hypertension ) or white coat syndrome high blood pressure ( Hypertension ).

The most common cause of resistant high blood pressure ( Hypertension ), and the most difficult to treat, is what medical researchers commonly refer to as "patient noncompliance." The term "patient noncompliance" refers to situations where patients are not adherent to the prescribed medicines, but is not meant to imply the patient is always to blame. To the contrary, most cases of "noncompliance" actually indicate that circumstances not in the patient's control have made following the recommended therapy either impractical or intolerable.

Patients are sometimes placed in instances where the recommended drug is very expensive, or the pharmacy shop is very far away, or doctor appointments are difficult to keep. More commonly, prescribed medications may have side effects, like dry cough headache or upset stomach or swelling of feet, of sufficient strength that the patient will stop taking the prescribed medicine to avoid suffering them. When side effects occur, the doctor usually changes to a drug that is better tolerated. But what happens if you've tried all the different medicines and the only one that works is the one that gives you the worst upset stomach? Clearly, situations like this require a great deal of thoughtful problem solving.

Because resistant high blood pressure ( Hypertension ) is usually the result of some underlying cause, treatment focuses on correcting this underlying cause. For example, in cases where the resistant high blood pressure ( Hypertension ) is caused by patient noncompliance, doctors will work with the patient to determine the root issue of the noncompliance and to remove it. In situations where the body fluid balance is abnormal, usually as a result of kidney disease, measures such as dialysis might be necessary. If a hormone imbalance is the cause of the resistant high blood pressure ( Hypertension ), then treatment efforts are focused on correcting the patient’s hormone profile or surgery for adrenals.

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