A 57-year-old female patient, we will call Patient X, was seen for high blood pressure.
Her history included being managed by her internist for one year without any significant reduction in her blood pressure. She was on three blood pressure medications: Ace inbibitor, beta block and calcium channel blocker. What was interesting was the fact she had an excellent lifestyle, ate a clean diet, was at her perfect weight, did moderate exercise five days a week and routine lipids were excellent.
Even with all of this, the lowest she could get her blood pressure was 160s over 90s. Her internist was stumped on what to do next.
When patient X was consulted, I carefully reviewed her case and decided to order four 24 hour urine tests. These included: Catecholamines, Metanephrines, Vanillylmandelic Acid and Aldosterone. The results were positive for elevated Aldosterone and Vanillylmandelic Acid.
Hyperaldosteronism can be caused by a tumor (usually a noncancerous adenoma) in the adrenal gland and will commonly cause high blood pressure. I discussed these results with her internist and he decided to order diagnostic imaging of the adrenal glands and prescribed the medication spironolactone which will block aldosterone.
I am happy to say that patient X’s blood pressure significantly dropped to the low 120s over 70s. The diagnostic imaging detected a moderate-sized adenoma, and the patient was referred to an endocrinologist for surgical removal.
It has been three months since the surgery, and patient X’s blood pressure is perfectly normal, and she is entirely off all blood pressure medications.
This was a good case study to help you expand your thinking when working with resistant blood pressure reduction despite all traditional and alternative treatment protocols.