Adult Patient with Pseudo-Resistant Hypertension: High Blood Pressure Induced by Exogenous Substances

  • Massimo Salvetti
Part of the Practical Case Studies in Hypertension Management book series (PCSHM)


In a significant proportion of patients referred to specialist’s evaluation for resistant hypertension, an appropriate approach may reveal reversible factors responsible for poor BP control. In these patients, after the assessment of adherence to lifestyle measures and to drug treatment, the diagnostic workup should include the evaluation of possible secondary forms of hypertension. An accurate evaluation of the drugs and substances assumed by the patient may sometimes unveil the cause of treatment resistance. Particular attention should be paid to the possible effect of several classes of pharmacological agents on BP. In addition, the assumption of illicit drugs, liquorice and use of nasal sprays should be systematically evaluated. In the case presented in this article, ingestion of large amounts of liquorice led to severe, treatment-resistant hypertension in a young female patient.


Resistant Hypertension Normal Heart Rate Home Blood Pressure Primary Hypothyroidism Glycyrrhetinic Acid 
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Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  • Massimo Salvetti
    • 1
  1. 1.ASST Spedali Civili di BresciaClinica Medica-University of BresciaBresciaItaly

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