Journal of Hypertension: Open Access

hypertension

Adrenal cortical adenoma related primary aldosteronism being a rare case ata young age is amedical challenge for clinical diagnosis. A 31-year-old male patient is reported with uncontrolled hypertension even after adhering to medication therapy for past 10 years. His laboratory findings and CT scan revealed the underlying cause as hypertension with adrenal carcinoma confirmed by adrenal vein sampling showing elevated aldosterone/renin ratio and hypokalaemia. A laparoscopic surgical intervention subsided his uncontrolled hypertension for the past 10 years. This rare case report highlights the necessity of differential diagnosis and points out the importance of diagnostic techniques to rule out specific underlying causes of especially common diseases like hypertension.

Background: Hypertension is a sever illness causing from high blood pressure through the arteries during circulation. Clinically, if the individual’s systolic blood pressure is greater than or equal to 140 mmHg and/or diastolic blood pressure is greater than or equal to 90 mmHg then a person is said to be hypertensive.

Methods: A retrospective study was conducted to obtain secondary data among hypertensive patients receiving antihypertensive treatment in between1st September 2014 to30th August 2016 in Debre Berhan referral hospital. Demographic covariates and clinical factors like age, gender, marital Status, residence, educational status, family history, alcohol status, salt use, time, body mass index and regime were considered. The data was extracted from the patient record cards. Patients, who have fulfilled the inclusion criteria, were included in the study. The data consists of 300 individuals. The average follow-up time was six month gap in order to see the difference clearly.

Results: Unstructured variance covariance structure was computed for the separate longitudinal analyses. The variability of the two biomarkers between individuals seems higher at baseline and appears to decrease over time after patients were initiated on treatment. In final saturated linear mixed model for systolic blood pressure the main effects BMI, Age (40-60), Residence (Urban), Salt (Yes) and Alcohol (Yes) were significant. And also for diastolic blood pressure the main effects BMI, Age (40-60), Residence (Urban), Salt (Yes), Regime (Hydrocholorothizide + Enalapril) and Alcohol (Yes) were significant at the 0.05 significance level.

Conclusions: In this study, two models were considered for fitting two response variables measured longitudinally. Based on the separate analysis the progression of SBP and DBP measures were significantly differ with respect to the main effect independent variables time, sex(female), Age(40-60), residence, salt, alcohol and their interaction time.