Truly resistant hypertension?

A young man presented with severe hypertension with evidence of both neurological and cardiovascular end-organ damage. Investigation revealed a small right kidney and a left renal artery aneurysm. Significant hypertension persisted even after right nephrectomy. Despite extensive investigation, no ev...

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Published inBMJ Case Reports Vol. 2012
Main Authors Goodlad, Cate, Unwin, Robert, Reaich, David, Cross, Jennifer
Format Report
LanguageEnglish
Published BMJ Publishing Group Ltd 2012
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Abstract A young man presented with severe hypertension with evidence of both neurological and cardiovascular end-organ damage. Investigation revealed a small right kidney and a left renal artery aneurysm. Significant hypertension persisted even after right nephrectomy. Despite extensive investigation, no evidence was found to implicate the aneurysm in the causation of his high blood pressure. No alternative cause for hypertension was found, yet blood pressure was high even during hospital admission and observed medication dosing with eight antihypertensive agents. Sustained hypertension resulted in worsening left ventricular hypertrophy and he died suddenly at a tragically young age several years after presentation. This gentleman had truly resistant hypertension, a clinical problem which can be very difficult to manage.
AbstractList A young man presented with severe hypertension with evidence of both neurological and cardiovascular end-organ damage. Investigation revealed a small right kidney and a left renal artery aneurysm. Significant hypertension persisted even after right nephrectomy. Despite extensive investigation, no evidence was found to implicate the aneurysm in the causation of his high blood pressure. No alternative cause for hypertension was found, yet blood pressure was high even during hospital admission and observed medication dosing with eight antihypertensive agents. Sustained hypertension resulted in worsening left ventricular hypertrophy and he died suddenly at a tragically young age several years after presentation. This gentleman had truly resistant hypertension, a clinical problem which can be very difficult to manage.
Author Cross, Jennifer
Unwin, Robert
Goodlad, Cate
Reaich, David
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  fullname: Goodlad, Cate
  organization: Department of Nephrology, North Middlesex Hospital, London, UK
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  givenname: Robert
  surname: Unwin
  fullname: Unwin, Robert
  organization: UCL Centre for Nephrology, UCL, London, UK
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  givenname: David
  surname: Reaich
  fullname: Reaich, David
  organization: Department of Nephrology The James Cook University Hospital, Middlesbrough, UK
– sequence: 4
  givenname: Jennifer
  surname: Cross
  fullname: Cross, Jennifer
  organization: UCL Centre for Nephrology, UCL, London, UK
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