Patient Profile
(Hormonal Blood Pressure Dysregulation)
Name: Susan Martinez
Age: 47 years
Medical History: Recently diagnosed with primary aldosteronism, history of hypertension, family history of type 2 diabetes
Lifestyle: Moderately active, high-stress job
Presenting Symptoms
Susan visits her doctor with concerns about her increasingly difficult-to-control blood pressure and general fatigue. She also reports episodes of muscle weakness and occasional headaches.
Diagnostic Process
Blood Pressure Monitoring: Persistent hypertension despite standard antihypertensive treatment.
Laboratory Tests: Blood tests show high aldosterone levels and low plasma renin activity, indicative of primary aldosteronism. Elevated levels of angiotensinogen and angiotensin II are also noted.
Confirmatory Testing: An adrenal CT scan is performed, revealing a small adenoma on her left adrenal gland.
Diagnosis
Susan is diagnosed with primary aldosteronism, likely contributing to her resistant hypertension. The elevated angiotensinogen and angiotensin II levels are significant factors in her blood pressure dysregulation.
Treatment Plan
Targeting Aldosteronism: She is prescribed a mineralocorticoid receptor antagonist to directly address the overproduction of aldosterone.
RAS Modulation: An ACE inhibitor is added to her treatment regimen to manage the high angiotensin II levels.
Lifestyle Adjustments: Dietary advice is given to reduce sodium intake and increase potassium. Stress management techniques are recommended to address her high-stress lifestyle.
Follow-Up and Monitoring
Regular follow-ups are scheduled to monitor her blood pressure, electrolyte levels, and hormonal profile.
Adjustments to her medication regime are made based on her response to treatment.
She undergoes periodic adrenal imaging to monitor the status of the adenoma.
Patient Education
Susan receives education about primary aldosteronism and its impact on blood pressure and overall health.
She is informed about the importance of medication adherence and lifestyle modifications in managing her condition.
Conclusion
Susan Martinez’s case underscores the complex interplay between endocrine disorders and blood pressure regulation, particularly highlighting the role of angiotensinogen and angiotensin. It demonstrates the importance of a comprehensive approach in diagnosing and treating conditions like primary aldosteronism, where hormonal imbalances significantly impact blood pressure control. By addressing the underlying endocrine disorder and modifying the RAS, alongside lifestyle interventions, her healthcare team aims to effectively manage her hypertension and improve her quality of life. This case study illustrates the intricacies of hormonal regulation in hypertension and the need for personalized treatment strategies in such scenarios.