The American College of Cardiology has released its 2026 Expert Consensus Decision Pathway on Resistant Hypertension, published in JACC.
This document provides a practical framework to translate evidence into clinical care.
Key priorities include:
Accurate and standardized BP measurement.
- Distinguishing true resistant hypertension from pseudoresistance, including medication nonadherence.
- Optimizing pharmacological and nonpharmacological treatment.
- Overcoming therapeutic inertia through multidisciplinary care.
- Considering emerging therapies and renal denervation in appropriately selected patients.
My perspective: Resistant hypertension is not simply a problem of choosing another antihypertensive drug. It is also a challenge of diagnosis, implementation, and long-term patient engagement.
The real question is not only what treatment should we add? but also have we identified why blood pressure remains uncontrolled?
An important contribution to improving hypertension management worldwide.
- Davis et al. JACC, 2026. https://doi.org/10.1016/j.jacc.2026.08.028
