<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1692-7273</journal-id>
<journal-title><![CDATA[Revista Ciencias de la Salud]]></journal-title>
<abbrev-journal-title><![CDATA[Rev. Cienc. Salud]]></abbrev-journal-title>
<issn>1692-7273</issn>
<publisher>
<publisher-name><![CDATA[Editorial Universidad del Rosario]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1692-72732018000300571</article-id>
<article-id pub-id-type="doi">10.12804/revistas.urosario.edu.co/revsalud/a.7272</article-id>
<title-group>
<article-title xml:lang="en"><![CDATA[Resistant Hypertension: A Clinical Case]]></article-title>
<article-title xml:lang="es"><![CDATA[Hipertensión resistente: un caso clínico]]></article-title>
<article-title xml:lang="pt"><![CDATA[Hipertensão resistente: um caso clínico]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Cascais Costa MD]]></surname>
<given-names><![CDATA[Joana]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Rua MD]]></surname>
<given-names><![CDATA[João]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Silva MD]]></surname>
<given-names><![CDATA[Amílcar]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Rodrigues MD PhD]]></surname>
<given-names><![CDATA[Adriano]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Centro Hospitalar e Universitário de Coimbra  ]]></institution>
<addr-line><![CDATA[Coimbra ]]></addr-line>
<country>Portugal</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>04</month>
<year>2018</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>04</month>
<year>2018</year>
</pub-date>
<volume>16</volume>
<numero>3</numero>
<fpage>571</fpage>
<lpage>577</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.co/scielo.php?script=sci_arttext&amp;pid=S1692-72732018000300571&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.co/scielo.php?script=sci_abstract&amp;pid=S1692-72732018000300571&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.co/scielo.php?script=sci_pdf&amp;pid=S1692-72732018000300571&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Introduction: Secondary hypertension corresponds to 15 % of the causes of arterial hypertension, and among them, primary hyperaldosteronism presents a variable incidence of about 3 % in hypertensive patients. It has a slightly higher prevalence in women, between 30 and 60 years, and is usually unilateral.  Case presentation: The authors describe the clinical case of a patient, followed by a severe hypertension medicated with four antihypertensive drugs for tension stabilization, maintaining systolic arterial tensions superior to 170 mmHg. In the aetiological study of hypertension, analytical alterations suggested hyperaldosteronism and a nodular lesion was detected in the left adrenal gland. The patient was submitted to surgery and excision of the lesion was done with histological confirmation of the diagnosis of corticomedullary adenoma of the adrenal gland. The patient presented improvement of the tension profile, with need to suspend two of the four antihypertensive drugs and to reduce the dose of the remaining ones.  Conclusion: A tumor of the adrenal cortex producing aldosterone is the main cause of primary hyperaldosteronism and should always be excluded when the presence of difficult to control, severe hypertension is detected, since the standard treatment is surgical, leading to a stabilization of the tension pattern after a few months.]]></p></abstract>
<abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen  Introducción: la hipertensión secundaria corresponde al 15 % de las causas de hipertensión arterial, y entre ellas, el hiperaldosteronismo primario presenta una incidencia variable de sobre 3 % en pacientes hipertensos. Tiene una prevalencia ligeramente mayor en mujeres, entre 30 y 60 años, y generalmente es unilateral.  Presentación del caso: los autores describen el caso clínico de un paciente, seguido por una hipertensión resistente medicada con cuatro fármacos antihipertensivos para la estabilización de la tensión, con mantenimiento de las tensiones arteriales sistólicas superiores a 170 mmHg. Las alteraciones analíticas en el estudio etiológico de la hipertensión sugirieron hiperaldosteronismo y una lesión nodular en la glándula suprarrenal izquierda. El paciente fue sometido a cirugía y se realizó la escisión de la lesión con confirmación histológica del diagnóstico de adenoma corticomedular de la glándula suprarrenal. El paciente presentó una mejora en el perfil de tensión, con la necesidad de suspender dos de los cuatro fármacos antihipertensivos y reducir la dosis de los restantes.  Discusión: un tumor de la corteza suprarrenal que produce la aldosterona es la principal causa de hiperaldosteronismo primario y siempre debe excluirse cuando se presenta hipertensión grave, difícil de controlar, ya que el tratamiento estándar es quirúrgico y conduce a una estabilización del patrón de tensión después de unos meses.]]></p></abstract>
<abstract abstract-type="short" xml:lang="pt"><p><![CDATA[Resumo  Introdução: a hipertensão secundária corresponde ao 15 % das causas de hipertensão arterial, e entre elas, o hiperaldosteronismo primário apresenta uma incidência variável de sobre 3 % em pacientes hipertensos. Tem uma prevalência ligeiramente maior em mulheres, entre 30-60 anos, e geralmente é unilateral.  Apresentação do caso: os autores descrevem o caso clínico de um paciente, seguido por uma hipertensão resistente medicada com quatro fármacos anti-hipertensivos para a estabilização da tensão, com manutenção das tensões arteriais sistólicas a 170 mmHg. As alterações analíticas no estudo etiológico da hipertensão sugeriram hiperaldosteronismo e uma lesão nodular na glândula suprarrenal esquerda. O paciente foi submetido a cirurgia e se realizou a incisão da lesão com confirmação histológica do diagnóstico de adenoma córtico-medular da glândula suprarrenal. O paciente apresentou uma melhora no perfil de tensão, com a necessidade de suspender dois dos quatro fármacos anti-hipertensivos e reduzir a dose dos restantes.  Discussão: um tumor do córtex suprarrenal que produz a aldosterona é a principal causa de hiperaldosteronismo primário e sempre deve excluir-se quando se apresenta hipertensão grave, difícil de controlar, pois o tratamento standard é cirúrgico e conduz a uma estabilização do patrão de tensão depois de uns meses.]]></p></abstract>
<kwd-group>
<kwd lng="en"><![CDATA[Conn's adenoma]]></kwd>
<kwd lng="en"><![CDATA[adrenal adenoma]]></kwd>
<kwd lng="en"><![CDATA[arterial hypertension]]></kwd>
<kwd lng="en"><![CDATA[secondary hypertension]]></kwd>
<kwd lng="en"><![CDATA[primary aldosteronism]]></kwd>
<kwd lng="en"><![CDATA[resistant hypertension]]></kwd>
<kwd lng="es"><![CDATA[adenoma de Conn]]></kwd>
<kwd lng="es"><![CDATA[adenoma adrenal]]></kwd>
<kwd lng="es"><![CDATA[hipertensión arterial]]></kwd>
<kwd lng="es"><![CDATA[hipertensión secundaria]]></kwd>
<kwd lng="es"><![CDATA[aldosteronismo primario]]></kwd>
<kwd lng="es"><![CDATA[hipertensión resistente]]></kwd>
<kwd lng="pt"><![CDATA[Conn's adenoma]]></kwd>
<kwd lng="pt"><![CDATA[adrenal adenoma]]></kwd>
<kwd lng="pt"><![CDATA[hipertensão arterial]]></kwd>
<kwd lng="pt"><![CDATA[hipertensão secundária]]></kwd>
<kwd lng="pt"><![CDATA[aldos-teronismo primário]]></kwd>
<kwd lng="pt"><![CDATA[hipertensão resistente]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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