A 30-year-old woman presented with uncontrolled hypertension, despite metoprolol 200
mg and perindopril 10 mg. Her medical history included hypertension for the past 5
years, a trauma, an eye operation, and gestational diabetes. The patient complained
of headaches, palpitations, polydipsia, polyuria, and panic attacks. She denied drug
abuse and had stopped oral contraceptives. Salt intake was moderate, and body mass
index was 26 kg/m2. The family was positive for hypertension. Office blood pressure (BP) was 172/130
mm Hg without significant left–right differences. Her 24-hour BP averaged 123/80 mm
Hg, with a nocturnal fall of 9%. Renal function was normal, and hypokalemia (3.0 mmol/L)
was resistant to 3600 mg potassium daily. Proteinuria, left ventricular hypertrophy,
and hypertensive retinopathy were absent. Medication was switched to doxazosine 4
mg and nifedipine retard 30 mg to test for secondary hypertension.
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Article info
Publication history
Published online: April 18, 2016
Footnotes
Funding: None.
Conflict of Interest: None.
Authorship: All authors had access to the data and a role in writing the manuscript.
Identification
Copyright
© 2016 Elsevier Inc. All rights reserved.
