Abstract
A 73-year-old man with a 10-year history of hypertension exhibited poorly controlled systolic blood pressure (BP), which remained at 190 mm Hg, despite treatment with six different classes of antihypertensives in the past 2 years. Laboratory analysis revealed potassium levels of 3.9 mmol/l, plasma aldosterone concentration (PAC) of 8.42 ng/dl (3.7–24.0 ng/dl), plasma renin activity (PRA) of 0.21 ng/ml/h (0.15–2.33 ng/ml/h), aldosterone-to-renin ratio (ARR) of 40.1 (>30), 24-h urinary vanillylmandelic acid levels of 1.67 mg (<7.5 mg/24 h) and 8:00 AM …
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