The reasons why renal hypertension is difficult to lower are as follows.
(1) Poor response of the patient to drugs and the continuous release of blood pressure-raising substances from the kidneys. The disease is mainly caused by renal parenchymal lesions and renal vascular lesions, where renal parenchymal lesions can lead to renal excretory dysfunction, causing water and sodium retention, as well as a poor response to diuretics. Renal vascular disease can lead to ischaemia in the kidneys, which in turn leads to the continuous release of blood pressure-raising renin, making renal hypertension difficult to control.
(2) Patients have poor compliance with medication. Kidney disease is a chronic disease, and it requires long-term adherence to lowering blood pressure. Patients may stop or reduce their medication without permission, resulting in repeated blood pressure.
(3) Single use of antihypertensive drugs. Renal hypertension requires a combination of 2 to 4 antihypertensive drugs to lower blood pressure, but the proportion of combined use of antihypertensive drugs in China is small, resulting in difficult control of renal hypertension.