[Arterial hypertension and increased urinary catecholamines]

Area of Science:

• Cardiology
• Nephrology
• Toxicology

Background:

• Arterial hypertension is a significant cardiovascular risk factor.
• Elevated urinary catecholamines can indicate phaeochromocytoma or other conditions.
• Refractory hypertension necessitates thorough diagnostic evaluation.

Observation:

• A 39-year-old male presented with persistent, difficult-to-treat arterial hypertension.
• Initial investigations focused on phaeochromocytoma due to elevated urinary free catecholamines.
• The patient's clinical presentation and work-up led to an alternative diagnosis.

Findings:

• The diagnostic work-up excluded phaeochromocytoma.
• Cocaine use was identified as the cause of the patient's arterial hypertension.
• This case underscores cocaine's hypertensive effects.

Implications:

• Clinicians should consider drug-induced causes, such as cocaine, in patients with refractory hypertension and elevated catecholamines.
• Understanding the pathogenesis of cocaine-induced hypertension is crucial for effective management.
• Differential diagnosis of elevated urinary catecholamines should include substance abuse.