Optimal medical treatment of difficult-to-treat hypertension

Description of the study: Hypertension remains the most important modifiable cardiovascular risk factor. Based on the results of the NATPOL and WOBASZ surveys, there are an estimated 11 million people with hypertension in Poland. Hypertension also represents a significant burden on the health care system. The 2018 ESC/ESH guidelines place significant emphasis on blood pressure control in the population under 65 years of age recommending that new lower blood pressure targets (120-129/70-79mmHg) be achieved in this group. Project hypothesis: in patients with uncontrolled hypertension under treatment with 3 or more hypotensive drugs (single- or dual-drug formulations), the optimal management to achieve new lower blood pressure targets is to replace the existing treatment with a combination formula based on the optimal combination of three hypotensive drugs, and in case of further failure, to use an aldosterone antagonist or loop diuretic.