What to do if your blood pressure is persistently high and cannot be lowered

If the patient has acute or subacute hypertension, the patient should immediately order antihypertensive drugs such as sodium nitroprusside and uradil to control the blood pressure within the appropriate range. Whether the patient’s lifestyle has been improved, such as whether the weight and salt intake have been effectively controlled, whether the patient has excessive alcohol consumption, has not quit smoking and other reasons that make it difficult to control blood pressure. In addition, whether the patient has taken some drugs that affect the blood pressure lowering drugs, such as tricyclic antidepressants and cyclosporine, can cause an increase in blood pressure due to increased vascular resistance, and whether the patient has taken oral contraceptives and glucocorticoids, which also have the effect of antagonizing the blood pressure lowering drugs. Patients with excessive sodium intake in the diet can counteract the effect of antihypertensive drugs. Obesity, diabetes, kidney damage and chronic renal insufficiency can sometimes lead to volume overload, and these patients may also have difficulty controlling their blood pressure. The presence of insulin resistance, diabetes mellitus, and other major causes of intractable hypertension may also be considered, as well as the presence of secondary hypertensive factors such as pheochromocytoma, cortisolism, and secondary hypertension caused by renal or renal vascular disease.