To the Editor I am writing about the recently published Review on the diagnosis and management of resistant hypertension. While acknowledging the clinical relevance and clarity of the Review, there are 3 key aspects that I believe warrant further discussion: (1) the definition and clinical significance of controlled resistant hypertension, (2) the important role of diagnostic pathways in distinguishing true from apparent resistant hypertension, and (3) the need for a more adaptable, phenotype-informed approach to fourth-line therapy in light of emerging evidence.