ARTERIAL HYPERTENSION: A HEAVY BURDEN ON THE HEALTHCARE SYSTEM AND THE ROLE OF BETA-BLOCKERS IN RESISTANT HYPERTENSION (LITERATURE REVIEW)

Hypertension is a major global health concern, affected 2/3 of adult population. According to WHO observational study only 21% of patients achieving adequate blood pressure control worldwide. Hypertension significantly increases cardiovascular risks, including ischemic heart disease, stroke, heart failure, and overall mortality. According meta-analysis, a 10-mmHg reduction in systolic blood pressure leads to 20% reduction in major cardiovascular disease events, 17% reduction in coronary artery disease risk, 27% reduction in stroke risk, 28% reduction in heart failure risk, 13% reduction in overall mortality risk. Resistant hypertension (RHTN), affecting approximately 20-30% of individuals, is defined as uncontrolled blood pressure despite treatment with three antihypertensive agents. Current guidelines recommend adding a fourth agent, such as a beta-blocker, for RHTN. Evidence for beta-blocker use in RHTN is limited, mainly derived from the PATHWAY-2 trial, which showed that bisoprolol reduced systolic blood pressure. However, knowledge gaps exist regarding other beta-blockers, systolic and diastolic blood pressure outcomes, and efficacy in patients with CCB intolerance.