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.

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