Differential Diagnosis for Hypertension Resistant to Treatment
- Single Most Likely Diagnosis
- b) Cushing syndrome: This condition, caused by excess cortisol, can lead to resistant hypertension due to its effects on the cardiovascular system, including increased blood pressure. It's a relatively common cause of secondary hypertension that can be missed if not considered.
- Other Likely Diagnoses
- d) Renal artery stenosis: A narrowing of the arteries that carry blood to the kidneys, which can lead to hypertension that is difficult to control with standard treatments. This condition directly affects blood pressure regulation.
- a) Breathing disorder during sleep: Sleep apnea is known to contribute to resistant hypertension. The intermittent hypoxia and frequent awakenings can lead to increased sympathetic tone, contributing to elevated blood pressure.
- Do Not Miss Diagnoses
- c) Pheochromocytoma: Although rare, this tumor of the adrenal gland can cause episodic or sustained hypertension due to excessive catecholamine release. Missing this diagnosis could be fatal due to the potential for hypertensive crises.
- Rare Diagnoses
- Other rare causes might include hyperaldosteronism, hyperparathyroidism, and certain genetic disorders affecting blood pressure regulation. These are less common but should be considered if initial evaluations for more likely causes are negative.