Clínica de hipertensión

Diagnosis and care for resistant high blood pressure

The Hypertension Clinic provides specialized care for adults whose blood pressure stays high despite treatment or has been hard to control over time. This is called resistant hypertension.

Kidney and blood pressure specialists and other experts focus on finding and treating the causes of resistant hypertension. Sometimes, high blood pressure (hypertension) is linked to another condition, such as primary aldosteronism, obstructive sleep apnea or renal artery stenosis. When high blood pressure is linked to another condition it is called secondary hypertension. Lifestyle factors and genetics can make blood pressure harder to manage.

Your care team creates a personalized plan using the latest research and treatments. The goal is to lower blood pressure, reduce the risk of heart and kidney diseases, and improve long-term health. You also receive education and support to help manage your blood pressure every day.

The Hypertension Clinic at Mayo Clinic in Arizona, Florida and Minnesota is certified as a Comprehensive Hypertension Center by the American Heart Association.

What to expect at your first visit

You may be referred to the Hypertension Clinic by your healthcare professional. You also can schedule an appointment without a referral.

At your first visit, you receive a full exam and testing by kidney and high blood pressure specialists. The goal is to understand why your blood pressure stays high despite treatment and how it responds to different therapies.

Your evaluation may include:

• A physical exam.
• Blood and urine tests to check kidney function and hormone levels that affect blood pressure.
• A review of your current medicines, including how and when you take them and whether changes may help.
• Specialized tests to look for conditions that can cause high blood pressure.

Your care team may recommend remote blood pressure monitoring. This helps confirm high blood pressure. It also helps identify patterns, such as when your blood pressure is highest during the day or night.

Your care team reviews your results and works with you to create a personalized plan to manage your blood pressure and treat any underlying causes.

Who may benefit from the Hypertension Clinic?

Care at the Hypertension Clinic may be helpful if:

• Your blood pressure stays high even though you take several blood pressure medicines.
• Your blood pressure has been hard to control over time.
• You have high blood pressure along with kidney disease, heart disease or another health condition.
• Your healthcare professional recommends a specialty evaluation or you want a second opinion.

Your hypertension team

A team of specialists with expertise in high blood pressure and related conditions provides your care.

Your team may include:

• Kidney doctors, also called nephrologists.
• High blood pressure specialists.
• Heart doctors, also called cardiologists.
• Endocrinologists.
• Sleep medicine specialists.
• Radiologists.
• Surgeons.
• Integrative medicine specialists.
• Dietitians.
• Pharmacists.
• Nurse practitioners.
• Physician assistants.
• Nurses.

Specialists work together to share expertise and provide coordinated care across all aspects of your condition.

Advanced tests to find the cause of hypertension

The Hypertension Clinic offers specialized tests to help find the cause of high blood pressure and guide treatment.

Tests may include:

• Adrenal vein sampling. This minimally invasive test shows whether one or both adrenal glands make too much aldosterone, a hormone that can raise blood pressure.
• Renal angiography. This imaging test uses contrast material to look for narrowing or blockages in the blood vessels that supply the kidneys.
• Genetic testing. It can identify inherited forms of high blood pressure.
• Pharmacogenomic testing. It helps guide medicine choices based on how your genes affect your body's response to certain medicines.

Personalized treatment for hypertension

Treatment is tailored to your needs, goals and the cause of your high blood pressure. It may include:

• Education and support to help you manage your blood pressure.
• Close blood pressure monitoring to better understand when and why your blood pressure is high and how it responds to treatment.
• Lifestyle counseling to support healthy changes, including physical activity, weight management, stress reduction and improved sleep.
• Nutrition guidance to support heart-healthy food choices and meal planning.
• Medicines selected based on your condition, test results and genetics when appropriate.
• Treatment of related health conditions, such as kidney disease, heart failure, diabetes or obstructive sleep apnea.
• Integrative therapies, such as relaxation training, mindfulness, acupuncture, massage therapy or yoga.

When needed, specialists may recommend advanced procedures to treat the underlying cause of high blood pressure, including:

• Minimally invasive adrenal gland surgery to remove hormone-producing growths.
• Renal revascularization to improve blood flow in a narrowed kidney artery.
• Renal artery denervation, a minimally invasive procedure to calm overactive nerves in the kidney arteries.

Research and clinical trials

Mayo Clinic physician-scientists and other researchers study high blood pressure to understand the causes and improve diagnosis and treatment.

You may be able to take part in one of the many hypertension-related clinical trials at Mayo Clinic. Talk with your healthcare professional about whether a clinical trial may be right for you.

Learn more about Mayo Clinic's nephrology and hypertension research.