WHAT IS IN THE SHADOW – A CASE OF SECONDARY HYPERTENSION

Abstract

Objective: To present a case of secondary hypertension, to rule the importance of having evidence based recommendations. Design and method: We describe the case of a diabetic, dyslipidemic 63 years old man, with coronary artery disease-percutaneous coronary intervention (PCI) of right coronary artery (RCA) and of circumflex coronary artery(CCA) in 2016, hypertensive (ambulatory treatment: angiotensin-enzyme inhibitor, a calcium channel blocker, beta blocker and alpha2 central receptors) admitted in internal medicine ward with fronto-occipital headache, dizziness, hypertension (with a blood pressure value of 170/110 mmHg), hypokalemia (K 1.76 mmol/l). Taking into consideration the characteristics of the particularly case presented above, the patient is considered to meet the admission criteria. The abdominal CT scan revealed adrenal gland adenoma (1.8/1.4 cm). The diagnose of primary hiperaldosteronism is confirmed by the value of aldosteron/renine ratio (ARR 17). The patient's blood pressure and hypokalemia was influenced by the dose adjustment to the patient's ambulatory treatment and the administration of antimineralocorticoid and potassium supplement. Results: The new regimen reduced the blood pressure values, normalized the blood pressure and partially increased the potassium level (K 2.82 mmol/l). Conclusions: Although the prevalence of secondary hypertension is approximately 10 % the risks associated with are significantly higher. We reported a case of secondary hypertension with a good outcome despite it's severity.