Resistant hypertension (RH) is a condition in which patients with hypertension do not achieve BP levels lower than the proposed cut-off, regardless the optimal dose of 3 or more antihypertensive drugs, including a long-acting calcium channel blocker, a blocker of the renin-angiotensin system, and a diuretic. Much attention has been paid to RH in the last years given the body of evidence indicating RH patients are at higher risk for health-related negative outcomes (e.g., cardiovascular, renal, and brain diseases), are more expected to have medication side effects and early death.

The pathological basis of RH is not yet well-established and the view that it would be an overactivation of the mechanism(s) responsible for traditional hypertension is superficial and likely erroneous. This lack of knowledge undoubtedly reflects in the poor effectiveness of pharmacological treatment, leading to the need of further information on alternative therapies.

Based on these premises, the aim of this Special Issue is to collate original research and review articles that focus on suggesting underlying mechanisms that may be related to the genesis and progression of RH. The aim is indicating the main molecular pathways and systemic biomarkers that have been used for the development of drug therapy and patients’ identification. We are also interested in proposing potential pharmacological and non-pharmacological therapies that may collaborate with the management of RH patients.

Potential topics include but are not limited to the following:

• Pathophysiology of resistant hypertension (role of kidneys and the interplay between kidneys, autonomic nervous system, hypertension, and target organs, such as heart, vasculature, brain)
• Diagnostic assessment of a patient with resistant hypertension (ambulatory 24hrs blood pressure, cases of masked or white coat hypertension, dippers vs. non dippers, sleep apnea, assessment of compliance with urine sodium studies, etc.)
• Antihypertensive therapy in resistant hypertension (approaches to treatment, other measures such obstructive sleep apnea treatment, secondary hypertension, non-pharmacologic approach, ensuring compliance)
• Invasive treatment of resistant hypertension (renal denervation, newer techniques, U/S methods, baroreflex activation therapy, etc.)