Approaches and Challenges in Managing Treatment-Resistant Hypertension: A Case Report

Treatment-resistant hypertension (TRH) is defined by consistently elevated blood pressure readings unresponsive to medical management. In clinical practice, it poses a significant challenge due to the intertwining variables that may cause the issue to persist such as lifestyle, genetics, and other comorbidities, as opposed to simple medication non-adherence. This report describes the case of a 68-year-old female patient presenting for a routine follow-up with persistently elevated ambulatory blood pressure readings. The patient was compliant with her medication regimen and followed lifestyle modification guidelines. Physical exam and review of systems showed no changes relative to previous visits. Laboratory findings were insignificant other than a low estimated glomerular filtration rate (eGFr) of 52. The patient's condition was stable but required further management to bring blood pressure readings into or closer to optimal range. This case looks at how the patient was managed and the rationale behind these decisions based on the patient's clinical history. It also emphasizes the importance of regular monitoring and constant adjustment of medical management to treatment for patients with TRH due to its unrelenting nature.