Is another drug interfering with antihypertensive therapy?
Be sure to ask the patient about other drugs he or she may be taking. A variety of prescription and/or nonprescription agents may interact with the antihypertensive regimen. Most commonly missed are the over-the-counter agents, such as NSAIDs, nasal sprays, oral decongestants, and appetite-suppressants. All of these agents can induce hypertension or interfere with the action of selected antihypertensive drugs. A number of prescription as well as illicit drugs can also contribute to apparent resistance to treatment. 5. Rule out associated conditions. Never underestimate the importance of selected associated conditions. Excessive alcohol intake is the most common cause of reversible hypertension in our society, and both young and elderly patients must be questioned directly. Obstructive sleep apnea has been associated with resistant hypertension among patients who present with clinical features of obesity, excessive drowsiness, and observed apneic episodes during sleep. Obesity and insul
