Hypertension affects around one-third of the adult population in Australia and represents the leading modifiable risk factor for major adverse outcomes, accounting for 10.8 million deaths per year globally.

In Australia, elevated blood pressure (BP) alone is responsible for 43% of coronary heart disease, 41% of stroke, 65% of the burden of hypertensive heart disease, 38% of chronic kidney disease and 32% of atrial fibrillation.

To make things worse, patients with “resistant hypertension” – commonly defined as office BP that remains uncontrolled (systolic BP ≥ 140mmHg or diastolic BP ≥ 90mmHg) despite adherence to three or more different antihypertensive drug classes, including a diuretic, at maximally tolerated doses – are at even higher risk of cardiovascular and renal diseases compared with those with uncomplicated hypertension.

If ambulatory BP measurements are used to confirm the diagnosis of resistant hypertension, around 10–12% of patients with hypertension are identified as treatment resistant.