HYPERTENSION OF DIFFICULT CONTROL – A PSEUDO-RESISTANT HYPERTENSION CASE REPORT

Detalhes bibliográficos
Autor(a) principal: Moreira, Valter Filipe
Data de Publicação: 2022
Outros Autores: Ribeiro, Andreia, Araújo, Ricardo, Esteves, Vera
Tipo de documento: Artigo
Idioma: por
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: https://doi.org/10.58043/rphrc.21
Resumo: Introduction: Cardio and cerebrovascular diseases continue to be the leading cause of death worldwide, for which there are several risk factors, with arterial hypertension being the most prevalent. In 5-10% of cases of hypertension, there is a secondary cause, with situations that should lead to its suspicion such as young age or resistant hypertension. This corresponds to an uncontrolled hypertension despite being medicated, which must be approached with care and investigated. Clinical Case: A 44-year-old woman, with no relevant history, developed a new case of hypertension with multiple visits to the Emergency Department due to hypertensive crisis in late 2016. From the evaluation by her attending physician, it was found a case of difficult to control hypertension and the study for secondary causes was negative. She was correctly medicated, but after 6 months, with several adjustments in medication, she always had high blood pressure (BP) values, and was assumed as a case of resistant hypertension. In one of the reassessment appointments, after exploring the situation, the existence of depression and anxiety with poor adherence to treatment was found. It was decided to medicate and intercede in adherence to therapy and over time there was a stabilization of BP values. Discussion: This case demonstrates a situation of pseudo-resistant hypertension in a complex patient. There are several factors that can influence BP control, from therapeutic adherence to external factors that affect the lives of patients, such as work and family problems, anxiety and depression, elements that may have been the cause of the difficult control of hypertension. The comprehensive and individual approach to each situation, as well as the doctor-patient relationship, has a fundamental role in the control of each chronic disease.
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spelling HYPERTENSION OF DIFFICULT CONTROL – A PSEUDO-RESISTANT HYPERTENSION CASE REPORTUMA HIPERTENSÃO ARTERIAL DE DIFÍCIL CONTROLO – UM CASO DE PSEUDOHIPERTENSÃO RESISTENTEIntroduction: Cardio and cerebrovascular diseases continue to be the leading cause of death worldwide, for which there are several risk factors, with arterial hypertension being the most prevalent. In 5-10% of cases of hypertension, there is a secondary cause, with situations that should lead to its suspicion such as young age or resistant hypertension. This corresponds to an uncontrolled hypertension despite being medicated, which must be approached with care and investigated. Clinical Case: A 44-year-old woman, with no relevant history, developed a new case of hypertension with multiple visits to the Emergency Department due to hypertensive crisis in late 2016. From the evaluation by her attending physician, it was found a case of difficult to control hypertension and the study for secondary causes was negative. She was correctly medicated, but after 6 months, with several adjustments in medication, she always had high blood pressure (BP) values, and was assumed as a case of resistant hypertension. In one of the reassessment appointments, after exploring the situation, the existence of depression and anxiety with poor adherence to treatment was found. It was decided to medicate and intercede in adherence to therapy and over time there was a stabilization of BP values. Discussion: This case demonstrates a situation of pseudo-resistant hypertension in a complex patient. There are several factors that can influence BP control, from therapeutic adherence to external factors that affect the lives of patients, such as work and family problems, anxiety and depression, elements that may have been the cause of the difficult control of hypertension. The comprehensive and individual approach to each situation, as well as the doctor-patient relationship, has a fundamental role in the control of each chronic disease.Introdução: As doenças cardio e cerebrovasculares continuam a ser a principal causa de morte a nível mundial, para as quais existem diversos fatores de risco, sendo a hipertensão arterial (HTA) o mais prevalente. Em 5-10% dos casos de HTA, existe uma causa secundária, existindo situações que devem levar à sua suspeição como a idade jovem ou a HTA resistente. Esta corresponde a uma hipertensão não controlada apesar de medicada que deve ser abordada com cuidado e investigada. Caso Clínico: Mulher de 44 anos, sem antecedentes relevantes, apresenta HTA de novo com ida ao Serviço de Urgência (SU) diversas vezes por crises hipertensivas no final de 2016. Da avaliação no seu médico assistente, constata-se hipertensão de difícil controlo e estudo de hipertensão secundária negativo. Foi medicada corretamente, mas ao longo de 6 meses, com vários ajustes na medicação, apresentava sempre valores elevados de pressão arterial (PA), assumindo-se como um caso de HTA resistente. Numa das consultas de reavaliação, após exploração da situação, apura-se a existência de um quadro de depressão e ansiedade com má adesão ao tratamento. Decide-se medicar e intervir na adesão à terapêutica e ao longo do tempo verifica- se uma estabilização dos valores de PA. Discussão: Este caso demonstra uma situação de pseudo-HTA resistente numa doente complexa. Existem diversos fatores que podem influenciar o controlo tensional, desde a adesão terapêutica a fatores externos que afetam a vida dos doentes, como problemas laborais, familiares, ansiedade e depressão, elementos estes que podem ter sido a causa desta HTA de difícil controlo. A abordagem abrangente e individual de cada situação, bem como a relação médico-doente, tem um papel fundamental no controlo de cada doença crónica.Revista Portuguesa de Hipertensão e Risco Cardiovascular2022-05-28info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttps://doi.org/10.58043/rphrc.21https://doi.org/10.58043/rphrc.21Revista Portuguesa de Hipertensão e Risco Cardiovascular; N.º 85 (2021): Setembro / Outubro; 20-251646-8287reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPporhttps://revistahipertensao.pt/index.php/rh/article/view/21https://revistahipertensao.pt/index.php/rh/article/view/21/21Moreira, Valter FilipeRibeiro, AndreiaAraújo, RicardoEsteves, Verainfo:eu-repo/semantics/openAccess2024-02-03T07:36:25Zoai:ojs.revistahipertensao.pt:article/21Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T16:05:07.734335Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv HYPERTENSION OF DIFFICULT CONTROL – A PSEUDO-RESISTANT HYPERTENSION CASE REPORT
UMA HIPERTENSÃO ARTERIAL DE DIFÍCIL CONTROLO – UM CASO DE PSEUDOHIPERTENSÃO RESISTENTE
title HYPERTENSION OF DIFFICULT CONTROL – A PSEUDO-RESISTANT HYPERTENSION CASE REPORT
spellingShingle HYPERTENSION OF DIFFICULT CONTROL – A PSEUDO-RESISTANT HYPERTENSION CASE REPORT
Moreira, Valter Filipe
title_short HYPERTENSION OF DIFFICULT CONTROL – A PSEUDO-RESISTANT HYPERTENSION CASE REPORT
title_full HYPERTENSION OF DIFFICULT CONTROL – A PSEUDO-RESISTANT HYPERTENSION CASE REPORT
title_fullStr HYPERTENSION OF DIFFICULT CONTROL – A PSEUDO-RESISTANT HYPERTENSION CASE REPORT
title_full_unstemmed HYPERTENSION OF DIFFICULT CONTROL – A PSEUDO-RESISTANT HYPERTENSION CASE REPORT
title_sort HYPERTENSION OF DIFFICULT CONTROL – A PSEUDO-RESISTANT HYPERTENSION CASE REPORT
author Moreira, Valter Filipe
author_facet Moreira, Valter Filipe
Ribeiro, Andreia
Araújo, Ricardo
Esteves, Vera
author_role author
author2 Ribeiro, Andreia
Araújo, Ricardo
Esteves, Vera
author2_role author
author
author
dc.contributor.author.fl_str_mv Moreira, Valter Filipe
Ribeiro, Andreia
Araújo, Ricardo
Esteves, Vera
description Introduction: Cardio and cerebrovascular diseases continue to be the leading cause of death worldwide, for which there are several risk factors, with arterial hypertension being the most prevalent. In 5-10% of cases of hypertension, there is a secondary cause, with situations that should lead to its suspicion such as young age or resistant hypertension. This corresponds to an uncontrolled hypertension despite being medicated, which must be approached with care and investigated. Clinical Case: A 44-year-old woman, with no relevant history, developed a new case of hypertension with multiple visits to the Emergency Department due to hypertensive crisis in late 2016. From the evaluation by her attending physician, it was found a case of difficult to control hypertension and the study for secondary causes was negative. She was correctly medicated, but after 6 months, with several adjustments in medication, she always had high blood pressure (BP) values, and was assumed as a case of resistant hypertension. In one of the reassessment appointments, after exploring the situation, the existence of depression and anxiety with poor adherence to treatment was found. It was decided to medicate and intercede in adherence to therapy and over time there was a stabilization of BP values. Discussion: This case demonstrates a situation of pseudo-resistant hypertension in a complex patient. There are several factors that can influence BP control, from therapeutic adherence to external factors that affect the lives of patients, such as work and family problems, anxiety and depression, elements that may have been the cause of the difficult control of hypertension. The comprehensive and individual approach to each situation, as well as the doctor-patient relationship, has a fundamental role in the control of each chronic disease.
publishDate 2022
dc.date.none.fl_str_mv 2022-05-28
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dc.identifier.uri.fl_str_mv https://doi.org/10.58043/rphrc.21
https://doi.org/10.58043/rphrc.21
url https://doi.org/10.58043/rphrc.21
dc.language.iso.fl_str_mv por
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dc.relation.none.fl_str_mv https://revistahipertensao.pt/index.php/rh/article/view/21
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dc.publisher.none.fl_str_mv Revista Portuguesa de Hipertensão e Risco Cardiovascular
publisher.none.fl_str_mv Revista Portuguesa de Hipertensão e Risco Cardiovascular
dc.source.none.fl_str_mv Revista Portuguesa de Hipertensão e Risco Cardiovascular; N.º 85 (2021): Setembro / Outubro; 20-25
1646-8287
reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
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