Detection and management of a case of drug-resistant hypertension

Q Pharmacology, Toxicology and Pharmaceutics

Anales De La Real Academia Nacional De Farmacia Pub Date : 2024-07-01 DOI:10.53519/analesranf.2024.90.02.04

Antonio Toro Ruiz, Fernando López Carmona, M. J. Zarzuelo

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Abstract

Community pharmacies, with more patient interaction than primary care physicians (PCP), are well-positioned to detect medication-related problems (DRP). The case of José, 82, diagnosed with hypertension in 2002, highlights the collaborative role of pharmacists. Despite regular antihypertensive treatment, José’s blood pressure rose, prompting a thorough assessment of his medication history. A self-measurement of blood pressure (SMBP) revealed consistently high readings, leading to suspicion of primary hyperaldosteronism. Referral to the PCP was accompanied by a detailed referral letter, justifying the suspicion and recommending specific diagnostic tests. José experienced hypotension during a summer holiday, further substantiating the suspicion. Diagnostic tests, including an MRI, revealed a 2mm aldosterone-producing adenoma. While awaiting surgery, José maintained his antihypertensive therapy, with post-surgery evaluation planned. The case underscores the pharmacist’s crucial role in screening for resistant hypertension, collaborative care, and considering multiple factors in diagnostic decisions. Keywords: Adenoma; resistant hypertension; interprofessional collaboration

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一例耐药性高血压的检测和管理

与初级保健医生 (PCP) 相比，社区药房与患者有更多的互动，在发现药物相关问题 (DRP) 方面处于有利地位。82 岁的何塞（José）于 2002 年被诊断出患有高血压，他的病例凸显了药剂师的合作作用。尽管定期接受降压治疗，何塞的血压还是升高了，这促使他对自己的用药史进行了全面评估。自我血压测量（SMBP）显示他的血压读数一直很高，因此怀疑他患有原发性高醛固酮症。在转诊至初级保健医生的同时，还出具了一份详细的转诊信，说明了怀疑的理由，并建议进行具体的诊断性检查。何塞在暑假期间出现了低血压，进一步证实了这一怀疑。包括核磁共振在内的诊断性检查发现了一个 2 毫米的醛固酮腺瘤。在等待手术期间，何塞坚持服用降压药，并计划进行术后评估。该病例强调了药剂师在筛查抵抗性高血压、合作护理以及在诊断决策中考虑多种因素方面的关键作用：腺瘤；耐药性高血压；跨专业合作

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来源期刊

Anales De La Real Academia Nacional De Farmacia Pharmacology-

CiteScore

0.13

自引率

0.00%

发文量

期刊介绍： The Anales de la Real Academia Nacional de Farmacia� embraces all aspects of pharmaceutical sciences and is a quarterly journal that publishes basic and applied research on pharmaceutical sciences and related areas. It is a medium for reporting selected original and significant contributions to new pharmaceutical knowledge.