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MediumACC/AHA recognizes spironolactone as effective add-on for resistant hypertension. Clonidine/hydralazine/minoxidil are later options with adverse effects. Alpha-1 blockers are not preferred due to orthostasis and limited outcome data.HypertensionACC/AHA Guideline (2017): High Blood Pressure in Adults

A 55-year-old with HTN and T2D has resistant BP on ACE inhibitor, thiazide, and calcium channel blocker. Next add-on with mortality benefit in resistant HTN?

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