Resistant Hypertension: A Clinical Case

Introduction: Secondary hypertension corresponds to 15 % of the causes of arterial hypertension, and among them, primary hyperaldosteronism presents a variable incidence of about 3% in hypertensive patients. It has a slightly higher prevalence in women, between 30 and 60 years, and is usually unilat...

Full description

Autores:
Tipo de recurso:
Fecha de publicación:
2018
Institución:
Universidad del Rosario
Repositorio:
Repositorio EdocUR - U. Rosario
Idioma:
spa
eng
OAI Identifier:
oai:repository.urosario.edu.co:10336/29462
Acceso en línea:
https://doi.org/10.12804/revistas.urosario.edu.co/revsalud/a.7272
https://repository.urosario.edu.co/handle/10336/29462
Palabra clave:
Adenoma de Conn
Adenoma adrenal
Hipertensión arterial
Hipertensión secundaria
Aldosteronismo primario
Hipertensión resistente
Cardiología
Conn's adenoma
Adrenal adenoma
Arterial hypertension
Secondary hypertension
Primary aldosteronism
Resistant hypertension
Cardiology
Hipertensão arterial
Hipertensão secundária
Aldos-teronismo primário
Hipertensão resistente
Cardiologia
Rights
License
Abierto (Texto Completo)
id EDOCUR2_ebfe0e83c15918721f5f69b3fa3d20cf
oai_identifier_str oai:repository.urosario.edu.co:10336/29462
network_acronym_str EDOCUR2
network_name_str Repositorio EdocUR - U. Rosario
repository_id_str
dc.title.eng.fl_str_mv Resistant Hypertension: A Clinical Case
dc.title.TranslatedTitle.spa.fl_str_mv Hipertensión resistente: un caso clínico
dc.title.TranslatedTitle.por.fl_str_mv Hipertensão resistente: um caso clínico
title Resistant Hypertension: A Clinical Case
spellingShingle Resistant Hypertension: A Clinical Case
Adenoma de Conn
Adenoma adrenal
Hipertensión arterial
Hipertensión secundaria
Aldosteronismo primario
Hipertensión resistente
Cardiología
Conn's adenoma
Adrenal adenoma
Arterial hypertension
Secondary hypertension
Primary aldosteronism
Resistant hypertension
Cardiology
Hipertensão arterial
Hipertensão secundária
Aldos-teronismo primário
Hipertensão resistente
Cardiologia
title_short Resistant Hypertension: A Clinical Case
title_full Resistant Hypertension: A Clinical Case
title_fullStr Resistant Hypertension: A Clinical Case
title_full_unstemmed Resistant Hypertension: A Clinical Case
title_sort Resistant Hypertension: A Clinical Case
dc.subject.spa.fl_str_mv Adenoma de Conn
Adenoma adrenal
Hipertensión arterial
Hipertensión secundaria
Aldosteronismo primario
Hipertensión resistente
Cardiología
topic Adenoma de Conn
Adenoma adrenal
Hipertensión arterial
Hipertensión secundaria
Aldosteronismo primario
Hipertensión resistente
Cardiología
Conn's adenoma
Adrenal adenoma
Arterial hypertension
Secondary hypertension
Primary aldosteronism
Resistant hypertension
Cardiology
Hipertensão arterial
Hipertensão secundária
Aldos-teronismo primário
Hipertensão resistente
Cardiologia
dc.subject.keyword.eng.fl_str_mv Conn's adenoma
Adrenal adenoma
Arterial hypertension
Secondary hypertension
Primary aldosteronism
Resistant hypertension
Cardiology
dc.subject.keyword.por.fl_str_mv Hipertensão arterial
Hipertensão secundária
Aldos-teronismo primário
Hipertensão resistente
Cardiologia
description Introduction: Secondary hypertension corresponds to 15 % of the causes of arterial hypertension, and among them, primary hyperaldosteronism presents a variable incidence of about 3% in hypertensive patients. It has a slightly higher prevalence in women, between 30 and 60 years, and is usually unilateral. Case presentation: The authors describe the clinical case of a patient, followed by severe hypertension medicated with four antihypertensive drugs for tension stabilization, maintaining systolic arterial tensions superior to 170 mmHg. In the aetiological study of hypertension, analytical alterations suggested hyperaldosteronism and a nodular lesion was detected in the left adrenal gland. The patient was submitted to surgery and excision of the lesion was done with histological confirmation of the diagnosis of corticomedullary adenoma of the adrenal gland. The patient presented improvement of the tension profile, with the need to suspend two of the four antihypertensive drugs and to reduce the dose of the remaining ones. Conclusion: A tumor of the adrenal cortex producing aldosterone is the main cause of primary hyperaldosteronism and should always be excluded when the presence of di cult to control, severe hypertension is detected, since the standard treatment is surgical, leading to a stabilization of the tension pattern after a few months.
publishDate 2018
dc.date.created.spa.fl_str_mv 2018-10-09
dc.date.accessioned.none.fl_str_mv 2020-09-09T15:38:43Z
dc.date.available.none.fl_str_mv 2020-09-09T15:38:43Z
dc.type.eng.fl_str_mv article
dc.type.coarversion.fl_str_mv http://purl.org/coar/version/c_970fb48d4fbd8a85
dc.type.coar.fl_str_mv http://purl.org/coar/resource_type/c_6501
dc.type.spa.spa.fl_str_mv Artículo
dc.identifier.doi.none.fl_str_mv https://doi.org/10.12804/revistas.urosario.edu.co/revsalud/a.7272
dc.identifier.issn.none.fl_str_mv 2145-4507
1692-7273
dc.identifier.uri.none.fl_str_mv https://repository.urosario.edu.co/handle/10336/29462
url https://doi.org/10.12804/revistas.urosario.edu.co/revsalud/a.7272
https://repository.urosario.edu.co/handle/10336/29462
identifier_str_mv 2145-4507
1692-7273
dc.language.iso.none.fl_str_mv spa
eng
language spa
eng
dc.relation.citationEndPage.none.fl_str_mv 572
dc.relation.citationIssue.none.fl_str_mv No. 3
dc.relation.citationStartPage.none.fl_str_mv 567
dc.relation.citationTitle.none.fl_str_mv Revista Ciencias de la Salud
dc.relation.citationVolume.none.fl_str_mv Vol. 16
dc.relation.ispartof.eng.fl_str_mv Revista Ciencias de la Salud; Vol. 16 No. 3 (2018); 567-572
dc.relation.ispartof.spa.fl_str_mv Revista Ciencias de la Salud; Vol. 16 Núm. 3 (2018); 567-572
dc.relation.ispartof.por.fl_str_mv Revista Ciencias de la Salud; v. 16 n. 3 (2018); 567-572
dc.relation.uri.spa.fl_str_mv https://revistas.urosario.edu.co/index.php/revsalud/article/view/7272
dc.rights.coar.fl_str_mv http://purl.org/coar/access_right/c_abf2
dc.rights.acceso.spa.fl_str_mv Abierto (Texto Completo)
rights_invalid_str_mv Abierto (Texto Completo)
http://purl.org/coar/access_right/c_abf2
dc.format.mimetype.none.fl_str_mv application/pdf
dc.publisher.spa.fl_str_mv Universidad del Rosario
dc.publisher.department.none.fl_str_mv Escuela de Medicina y Ciencias de la Salud
dc.source.spa.fl_str_mv Revista Ciencias de la Salud
institution Universidad del Rosario
dc.source.instname.none.fl_str_mv instname:Universidad del Rosario
dc.source.reponame.none.fl_str_mv reponame:Repositorio Institucional EdocUR
bitstream.url.fl_str_mv https://repository.urosario.edu.co/bitstreams/e8903e12-9f5d-4a16-b819-1f29e34c3035/download
https://repository.urosario.edu.co/bitstreams/8062ae36-b8fa-4629-b34b-8b7d017fad98/download
https://repository.urosario.edu.co/bitstreams/7699b1f1-f80a-436e-824c-4835152907e2/download
bitstream.checksum.fl_str_mv eb84509ed54152162fa4dcc5c6d7e2e6
b20e8df909546f8b87a4d543e46113b0
94f2c9db4f5d4704f622dbbb6502b4fb
bitstream.checksumAlgorithm.fl_str_mv MD5
MD5
MD5
repository.name.fl_str_mv Repositorio institucional EdocUR
repository.mail.fl_str_mv edocur@urosario.edu.co
_version_ 1814167559921991680
spelling 925e8d21-38ba-404f-ac09-4712d7c519964099f96d-f5eb-4edf-8e29-76080abefbd4e32fad61-0270-448d-ad1e-7d2bda26c3247c01f95e-6fff-4fec-9a0c-3eeb953e66062020-09-09T15:38:43Z2020-09-09T15:38:43Z2018-10-09Introduction: Secondary hypertension corresponds to 15 % of the causes of arterial hypertension, and among them, primary hyperaldosteronism presents a variable incidence of about 3% in hypertensive patients. It has a slightly higher prevalence in women, between 30 and 60 years, and is usually unilateral. Case presentation: The authors describe the clinical case of a patient, followed by severe hypertension medicated with four antihypertensive drugs for tension stabilization, maintaining systolic arterial tensions superior to 170 mmHg. In the aetiological study of hypertension, analytical alterations suggested hyperaldosteronism and a nodular lesion was detected in the left adrenal gland. The patient was submitted to surgery and excision of the lesion was done with histological confirmation of the diagnosis of corticomedullary adenoma of the adrenal gland. The patient presented improvement of the tension profile, with the need to suspend two of the four antihypertensive drugs and to reduce the dose of the remaining ones. Conclusion: A tumor of the adrenal cortex producing aldosterone is the main cause of primary hyperaldosteronism and should always be excluded when the presence of di cult to control, severe hypertension is detected, since the standard treatment is surgical, leading to a stabilization of the tension pattern after a few months.Introducción: la hipertensión secundaria corresponde al 15% de las causas de hipertensión arterial, y entre ellas, el hiperaldosteronismo primario presenta una incidencia variable de sobre 3 % en pacientes hipertensos. Tiene una prevalencia ligeramente mayor en mujeres, entre 30 y 60 años, y generalmente es unilateral. Presentación de caso: los autores describen el caso clínico de un paciente, seguido por una hipertensión resistente medicada con cuatro fármacos antihipertensivos para la estabilización de la tensión, con mantenimiento de las tensiones arteriales sistólicas superiores a 170 mmHg. Las alteraciones analíticas en el estudio etiológico de la hipertensión sugirieron hiperaldosteronismo y una lesión nodular en la glándula suprarrenal izquierda. El paciente fue sometido a cirugía y se realizó la escisión de la lesión con confirmación histológica del diagnóstico de adenoma corticomedular de la glándula suprarrenal. El paciente presentó una mejora en el perfil de tensión, con la necesidad de suspender dos de los cuatro fármacos antihipertensivos y reducir la dosis de los restantes. Discusión: un tumor de la corteza suprarrenal que produce la aldosterona es la principal causa de hiperaldosteronismo primario y siempre debe excluirse cuando se presenta hipertensión grave, difícil de controlar, ya que el tratamiento estándar es quirúrgico y conduce a una estabilización del patrón de tensión después de unos meses.Introdução: a hipertensão secundária corresponde ao 15% das causas de hipertensão arterial, e entre elas, o hiperaldosteronismo primário apresenta uma incidência variável de sobre 3% em pacientes hipertensos. Tem uma prevalência ligeiramente maior em mulheres, entre 30-60 anos, e geralmente é unilateral. Apresentação do caso: os autores descrevem o caso clínico de um paciente, seguido por uma hipertensão resistente medicada com quatro fármacos anti-hipertensivos para a estabilização da tensão, com manutenção das tensões arteriais sistólicas a 170 mmHg. As alterações analíticas no estudo etiológico da hipertensão sugeriram hiperaldosteronismo e uma lesão nodular na glândula suprarrenal esquerda. O paciente foi submetido a cirurgia e se realizou a incisão da lesão com confirmação histológica do diagnóstico de adenoma córtico-medular da glândula suprarrenal. O paciente apresentou uma melhora no per l de tensão, com a necessidade de suspender dois dos quatro fármacos anti-hipertensivos e reduzir a dose dos restantes. Discussão: um tumor do córtex suprarrenal que produz a aldosterona é a principal causa de hiperaldosteronismo primário e sempre deve excluir-se quando se apresenta hipertensão grave, difícil de controlar, pois o tratamento standard é cirúrgico e conduz a uma estabilização do patrão de tensão depois de uns meses.application/pdfhttps://doi.org/10.12804/revistas.urosario.edu.co/revsalud/a.72722145-45071692-7273https://repository.urosario.edu.co/handle/10336/29462spaengUniversidad del RosarioEscuela de Medicina y Ciencias de la Salud572No. 3567Revista Ciencias de la SaludVol. 16Revista Ciencias de la Salud; Vol. 16 No. 3 (2018); 567-572Revista Ciencias de la Salud; Vol. 16 Núm. 3 (2018); 567-572Revista Ciencias de la Salud; v. 16 n. 3 (2018); 567-572https://revistas.urosario.edu.co/index.php/revsalud/article/view/7272Abierto (Texto Completo)http://purl.org/coar/access_right/c_abf2Revista Ciencias de la Saludinstname:Universidad del Rosarioreponame:Repositorio Institucional EdocURAdenoma de ConnAdenoma adrenalHipertensión arterialHipertensión secundariaAldosteronismo primarioHipertensión resistenteCardiologíaConn's adenomaAdrenal adenomaArterial hypertensionSecondary hypertensionPrimary aldosteronismResistant hypertensionCardiologyHipertensão arterialHipertensão secundáriaAldos-teronismo primárioHipertensão resistenteCardiologiaResistant Hypertension: A Clinical CaseHipertensión resistente: un caso clínicoHipertensão resistente: um caso clínicoarticleArtículohttp://purl.org/coar/version/c_970fb48d4fbd8a85http://purl.org/coar/resource_type/c_6501Cascais Costa, JoanaRua, João RuaSilva, AmílcarRodrigues, AdrianoORIGINALResistant-Hypertension.pdfResistant-Hypertension.pdfapplication/pdf236960https://repository.urosario.edu.co/bitstreams/e8903e12-9f5d-4a16-b819-1f29e34c3035/downloadeb84509ed54152162fa4dcc5c6d7e2e6MD51TEXTResistant-Hypertension.pdf.txtResistant-Hypertension.pdf.txtExtracted texttext/plain17274https://repository.urosario.edu.co/bitstreams/8062ae36-b8fa-4629-b34b-8b7d017fad98/downloadb20e8df909546f8b87a4d543e46113b0MD52THUMBNAILResistant-Hypertension.pdf.jpgResistant-Hypertension.pdf.jpgGenerated Thumbnailimage/jpeg3947https://repository.urosario.edu.co/bitstreams/7699b1f1-f80a-436e-824c-4835152907e2/download94f2c9db4f5d4704f622dbbb6502b4fbMD5310336/29462oai:repository.urosario.edu.co:10336/294622022-08-24 11:20:21.238269https://repository.urosario.edu.coRepositorio institucional EdocURedocur@urosario.edu.co