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Patient Cases 2. A Patient with Apparent Resistant Hypertension

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Abstract

True treatment-resistant hypertension (TRH) is defined by specific criteria and a failure to response to initial therapy options does not necessarily mean that a patient has TRH. In this case, a 44-year-old male was discharged on a fixed combination of valsartan/hydrochlorothiazide (HCTZ) 160/125 mg/day after presenting to the emergency room with paraesthesia of the upper left limb and recording a blood pressure (BP) of 190/110 mmHg. The patient had a number of other cardiovascular (CV) risk factors, and was determined to be at high risk of developing type 2 diabetes mellitus and of CV death. Carvedilol and atorvastatin were added, but 24-h ambulatory BP monitoring (ABPM) showed persistent hypertension. After specialist assessment, the patient’s antihypertensive regimen was switched to a fixed-dose combination of olmesartan/HCTZ in the morning and a fixed-dose combination of olmesartan/amlodipine in the evening. Repeat ABPM 6 weeks later showed better BP control then previous ABPM.

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Acknowledgments

The authors wish to thank Renata Perego, Nicola Ryan and Raelene Simpson, independent medical writers, who provided editorial assistance on behalf of Springer Healthcare Communications. This assistance was supported by the Menarini group.

Conflict of interest

Dr. Aguiar received speaker fees and honoraria for advisory board activities from Menarini, Daiichi Sankyo, Novartis, and Bial-Portela; the activities conducted with the support of the Menarini group do not constitute a conflict of interest in relation to the contents of this article.

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Authors and Affiliations

  1. Cardiology Department, Hospital de Santa Cruz, Carnaxide, Portugal

    Carlos Aguiar

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  1. Carlos Aguiar
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Correspondence to Carlos Aguiar.

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Aguiar, C. Patient Cases 2. A Patient with Apparent Resistant Hypertension. High Blood Press Cardiovasc Prev 22 (Suppl 1), 19–22 (2015). https://doi.org/10.1007/s40292-015-0111-6

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  • DOI: https://doi.org/10.1007/s40292-015-0111-6

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