Resistant Hypertension Clinic

Welcome to the South Denver Resistant Hypertension Clinic.

We have a multidisciplinary team of Physicians, Nurses and Registered Dietitian to educate, support and treat blood pressure that is difficult to control. 

Meet the Physicians of the South Denver Resistant Hypertension Clinic

Ira Dauber, M.D. – South Denver Cardiology







Jeff Giullian, M.D., MBA – South Denver Nephrology






Sameer Bisarya, M.D. – South Denver Nephrology




Services are offered on an outpatient basis and include individualized nutrition and exercise counseling, medical treatment and stress


The goal for blood pressure is less than 140/90 mmHg in average risk hypertensive patients. There is evidence supporting a lower goal blood pressure in patients with atherosclerotic cardiovascular disease, diabetes mellitus, or chronic kidney disease. Treating blood pressure ”to goal” reduces complications of hypertension.

What is Resistant Hypertension?
Hypertension is called resistant if a person’s blood pressure remains above goal despite their taking three medications to control their blood pressure. High blood pressure that is under control, but requires four or more medications to treat it is also considered resistant to treatment. Patients whose blood pressure is controlled with four or more medications are considered to have resistant hypertension

Why treat it differently?
Improved therapy can enhance your health.
Patients with Resistant Hypertension are at high risk of cardiovascular complications such as heart attack stroke, kidney failure, and other health issues. The treatment of resistant hypertension
undoubtedly is more complicated because it is so difficult to meet a goal blood pressure.

Why do I have Resistant Hypertension?
Sometimes the combination of medications needs to be adjusted but, doctors usually start looking for other medical problems that could contribute to high blood pressure. Some complications they may look for are,

• Congestive heart failure
• Abnormal hormone levels in the blood
• Narrowing of one or more arteries leading to the kidneys
• Sleep apnea
• Abnormal dietary intake
“Older age and obesity are two of the strongest risk factors associated with resistant hypertension.

How can it be treated?
Successful treatment of resistant hypertension requires consideration of lifestyle factors that contribute to treatment resistance, diagnosing and treating secondary causes of high blood pressure, using multiple-drug treatments effectively and the possibility of procedural intervention.

Lifestyle factors
• Obesity
• Higher than healthy dietary salt intake
• More than optimal alcohol intake
• Stress management
• Exercise
Secondary Causes of Hypertension
• Obstructive sleep apnea
• Renal parenchymal disease (kidney disease)
• Hormonal Imbalance or Endocrine Disorders (Cortisol, aldosterone, renin, thyroid)
• Renal artery stenosis
• Harmful food supplemants
• Withdraw interfering drugs
• Appropriate use of Diuretics
• Using Mineralocorticoid receptor antagonist
• New multi-drug regimens
• Adjusting dose timing
• Easier to take combinations
Procedural Treatment
• Renal sympathetic-nerve ablation is a newly developed method for treatment which can reduce blood pressure and decrease the number of medications needed to control blood pressure.
• Renal artery stenting

What’s next?
Talk to your physician today about the
South Denver Resistant Hypertension Clinic to see if it right for you.

For more information or to schedule an appointment call 303-703-2090