Primary hyperaldosteronism: a case report
DOI:
https://doi.org/10.32385/rpmgf.v39i6.13792Keywords:
Primary hyperaldosteronism, Hypertension, Case reportAbstract
Introduction: Secondary hypertension accounts for approximately 10% of cases of hypertension, including primary hyperaldosteronism. It is intended to draw attention to the importance of screening for secondary causes of hypertension when there are suspicious signs such as lack of tension control with three drugs which included a diuretic.
Case description: 75-year-old female patient with high blood pressure, dyslipidemia, chronic kidney disease, and hypokalemia. She had a consultation at her Family Health Unit, and at evaluation, she had high blood pressure. The tests showed high aldosterone and renin levels, hypokalemia, and an adrenal gland adenoma. Due to the suspicion of primary hyperaldosteronism, the patient was referred to an Endocrinology appointment, where the diagnosis was confirmed. She underwent an exeresis of the adenoma, and she is currently normotensive.
Comments: This case demonstrates how, in the face of a medicated patient with poor blood pressure control, the hypothesis of secondary hypertension should be considered, since correcting the cause can lead to blood pressure normalization and a reduction in cardiovascular risk.
Downloads
References
Kline GA, Prebtani AP, Leung AA, Schiffrin EL. Primary aldosteronism: a common cause of resistant hypertension. CMAJ. 2017;189(22):E773-8.
Williams B, Mancia G, Spiering W, Rosei SE, Azizi M, Burnier M, et al. 2018 ESC/ESH Guidelines for the management of arterial hypertension. Eur Heart J. 2018;39(33):3021-104.
Charles L, Triscott J, Dobbs B. Secondary hypertension: discovering the underlying cause. Am Fam Phys. 2017;96(7):453-61.
Heerspink HJ, Stefánsson BV, Correa-Rotter R, Chertow GM, Greene T, Hou FF, et al. Dapagliflozin in patients with chronic kidney disease. N Engl J Med. 2020;383(15):1436-46.
Hundemer GL, Vaidya A. Primary aldosteronism diagnosis and management: a clinical approach. Endocrinol Metab Clin North Am. 2019;48(4):681-700.
Allen J, Gay B, Crebolder H, Heyrman J, Svab I, Ram P, et al. A definição Europeia de medicina geral e familiar (clínica geral/medicina familiar) [The European definition of family medicine (general practice/family medicine)]. Rev Port Clin Geral. 2005;21(5):511-6. Portuguese
Downloads
Published
Issue
Section
License
Copyright (c) 2023 Portuguese Journal of Family Medicine and General Practice
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
The authors will assign to the RPMGF the sole right to publish and distribute the content of the manuscript specified in this declaration via physical, electronic, broadcasting or any other medium that may come into existence. They also grant the RPMGF the right to use and exploit this manuscript, in particular by assigning, selling or licensing its content. This permission is permanent and takes effect from the moment the manuscript is submitted, has the maximum duration allowed by applicable Portuguese or international law and is of worldwide scope. The authors further declare that this assignment is made free of charge. If the RPMGF informs the authors that it is not going to publish their manuscript, the exclusive assignment of rights ceases forthwith.
The authors authorise the RPMGF (or any entity it may appoint) to act on their behalf when it believes that copyright may have been infringed.
