Morano Julian, Kholoki Samer
Internal Medicine, Saint James School of Medicine, The Valley, AIA.
Internal Medicine, University of Chicago Medicine AdventHealth La Grange, Chicago, USA.
Cureus. 2024 Dec 11;16(12):e75554. doi: 10.7759/cureus.75554. eCollection 2024 Dec.
Treatment-resistant hypertension (TRH) is defined by consistently elevated blood pressure readings unresponsive to medical management. In clinical practice, it poses a significant challenge due to the intertwining variables that may cause the issue to persist such as lifestyle, genetics, and other comorbidities, as opposed to simple medication non-adherence. This report describes the case of a 68-year-old female patient presenting for a routine follow-up with persistently elevated ambulatory blood pressure readings. The patient was compliant with her medication regimen and followed lifestyle modification guidelines. Physical exam and review of systems showed no changes relative to previous visits. Laboratory findings were insignificant other than a low estimated glomerular filtration rate (eGFr) of 52. The patient's condition was stable but required further management to bring blood pressure readings into or closer to optimal range. This case looks at how the patient was managed and the rationale behind these decisions based on the patient's clinical history. It also emphasizes the importance of regular monitoring and constant adjustment of medical management to treatment for patients with TRH due to its unrelenting nature.
难治性高血压(TRH)的定义是血压读数持续升高,对药物治疗无反应。在临床实践中,由于生活方式、遗传因素和其他合并症等相互交织的变量可能导致问题持续存在,这与单纯的药物治疗依从性不佳不同,它构成了重大挑战。本报告描述了一名68岁女性患者的病例,该患者前来进行常规随访,其动态血压读数持续升高。患者遵守药物治疗方案并遵循生活方式改变指南。体格检查和系统回顾显示与之前就诊相比无变化。实验室检查结果除了估算肾小球滤过率(eGFr)低至52外无显著异常。患者病情稳定,但需要进一步治疗以使血压读数达到或接近最佳范围。本病例探讨了该患者的治疗方式以及基于患者临床病史做出这些决定的理由。它还强调了由于TRH的顽固性,对TRH患者进行定期监测和不断调整药物治疗的重要性。