We present the case of a 47-year-old male that presented with hypertensive emergency. Several diagnostic tests were performed prior to consideration of pheochromocytoma as the potential cause. [ncbi.nlm.nih.gov]

• Resistant Hypertension

  OBJECTIVE: To determine causes of treatment resistance in patients with refractory hypertension, and to estimate the prevalence of true resistant hypertension. [ncbi.nlm.nih.gov]

• Falling

  There was a fall in blood pressure with time (157/97 vs. 140/85) but this was associated with an increase in the amount of medication required (mean medication score 5.99 vs. 7.65). [ncbi.nlm.nih.gov]

  The stimulation of these central alpha-adrenergic receptors has been shown to activate an inhibiting neuron, which causes a reduction of peripheral sympathetic tone and a subsequent fall in arterial blood pressure and heart rate. [doi.org]

  If asked, patients may admit to having had one or more motor vehicle crashes or near crashes because of lack of attentiveness or falling asleep while driving. [aafp.org]

• Fatigue

  Patients may have difficulty describing their sleepiness and may call it “tiredness” or “fatigue.” Physicians should ask patients exactly what they mean, and they may have to ask directly, “Do you mean you are sleepy most of the time?” [aafp.org]

• Collapse

  The CPAP system acts as a physical pressure splint to prevent partial or complete collapse of the upper airway during sleep. [aafp.org]

• Snoring

  In most cases, patients cannot hear their own snoring. Even if they admit to being told that they snore, patients often have a tendency to underestimate the loudness and frequency of their snoring. [aafp.org]

• Failure to Thrive

  In the late 1960s, a severe form of hypertension that was characterized by low birth weight, failure to thrive, polyuria, and polydipsia was diagnosed in a 3-yr-old girl ( 1 ). [jasn.asnjournals.org]

• Nausea

  Arsenic exposure has also many of the same signs of primary hypertension such as headache, somnolence, confusion, proteinuria visual disturbances, and nausea and vomiting Due to the role of intracellular potassium in regulation of cellular pressures related [en.wikipedia.org]

• Thrombosis

  Hughes GR: Thrombosis, abortion, cerebral disease, and the lupus anticoagulant. BMJ (Clin Res Ed) 1983, 287: 1088–1089. CrossRef Google Scholar 2. [doi.org]

• Macroglossia

  […] in some cases Crowded mouth with low-extending soft palate sometimes present Large uvula Generalized erythema and swelling of all tissues including the pharyngeal pillars Large tonsils and adenoids may be present, especially in children Large tongue (macroglossia [aafp.org]

• Headache

  The aneurysms were duly treated with detachable coils and the clinical course with regard to the SAH was unremarkably safe for high-pressure headache. [ncbi.nlm.nih.gov]

  Arsenic exposure has also many of the same signs of primary hypertension such as headache, somnolence, confusion, proteinuria visual disturbances, and nausea and vomiting Due to the role of intracellular potassium in regulation of cellular pressures related [en.wikipedia.org]

  Genetic characteristics A similar hereditary pattern is present in OSA and EH Clinical findings Improve with weight loss Increased prevalence of snoring, cardiovascular complications, renal damage, cognitive dysfunction, headaches, impotence, non-dipping [aafp.org]

  He observed that small amounts of GTN placed on the tongue caused a violent headache, which led Constantin Hering to pursue the development of GTN as a homeopathic remedy for headache [ 6 ]. [doi.org]

• Difficulty Concentrating

  Patients who have OSA have a significantly greater chance of having a motor vehicle crash when compared with persons who do not have OSA. 6 Excessive daytime sleepiness may also manifest as difficulty concentrating, remembering things, or thinking clearly [aafp.org]

The determinant for workup is dependent on the index of suspicion elicited during patient examination and treatment. [ncbi.nlm.nih.gov]

Moreover, treatment resistance in hypertensive patients appears to be associated with insulin resistance. [ncbi.nlm.nih.gov]

[…] mineralocorticoid receptor antagonists and surgical treatment. [doi.org]

The prognosis is much more severe when pre-eclampsia develops very early in the pregnancy. The symptoms include elevated blood pressure (over 140 mmHg systolic, 90 mmHg diastolic) combined with proteinuria. [doi.org]

Prenat Diagn 24 : 327 –332, 2004 ↵ Boyer O, Gagnadoux MF, Guest G, Biebuyck N, Charbit M, Salomon R, Niaudet P: Prognosis of autosomal dominant polycystic kidney disease diagnosed in utero or at birth. [jasn.asnjournals.org]

Therefore, all children with confirmed hypertension should have an evaluation for an underlying etiology that includes renal ultrasonography. [ncbi.nlm.nih.gov]

The available data relevant to epidemiology of these conditions and age-dependent clinical characteristics are reviewed. [ncbi.nlm.nih.gov]

Epidemiology. 2001, 12: 570-576. 10.1097/00001648-200109000-00018. [doi.org]

[…] factor Physiologic responses Increased chemoreceptor sensitivity as seen by exaggerated pressor response and ventilation response to hypoxia Reduced baroreceptor sensitivity TABLE 2 Similarities Between Obstructive Sleep Apnea and Essential Hypertension Epidemiologic [aafp.org]

This article defines the disorder and details its epidemiology, prevalence, pathophysiology, physical findings, and treatment strategies. Copyright © 2014 Elsevier Inc. All rights reserved. [ncbi.nlm.nih.gov]

Google Scholar | Crossref | Medline | ISI Oda, N., Takeda, Y., Zhu, A., Usukura, M., Yoneda, T., Takata, H. et al. ( 2006 ) Pathophysiological roles of the adrenal renin-angiotensin system in patients with primary aldosteronism, Hypertens Res 29: 9 - [tak.sagepub.com]

[…] of High Blood Pressure" provides a new guideline for hypertension prevention and management. [doi.org]

Moreover, effective treatment of secondary hypertension can prevent chronic complications, such as left ventricular hypertrophy and coronary artery disease, which markedly increase morbidity and mortality. [ncbi.nlm.nih.gov]

ARB therapy prevents action of ANGII in the systemic and renal circulations by binding with ANGII 1a receptors. [cjasn.asnjournals.org]