open access

Vol 25, No 2 (2021)
Case report
Published online: 2021-05-18
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Difficult-to-control secondary hypertension in a patient with history of glioblastoma, and cerebral edema — a case study

Małgorzata Placek, Marta Sołtysiak, Jacek Drozdowski, Jacek Wolf
DOI: 10.5603/AH.a2021.0008
·
Arterial Hypertension 2021;25(2):88-91.

open access

Vol 25, No 2 (2021)
CASE REPORT
Published online: 2021-05-18

Abstract

We report a history of a patient with difficult-to-control high blood pressure, central nervous system mass and several comorbidities which altogether made the blood-lowering medication particularly challenging. Patient was diagnosed with glioblastoma, renovascular stenosis to a single kidney, and cerebral edema resulting from both cerebral tissue mass and exceedingly high systemic blood pressure. In the presented case we faced several contraindications to the guideline-recommended treatment with RAAS blockers, beta-blockers, and several diuretic classes which were determined by (1) the only remaining kidney’s renal artery stenosis, (2) decreased creatinine clearance and (3) reflex bradycardia secondary to cerebral edema. Evidence-based recommendations do not clarify all clinical aspects related to emergent high blood pressure because the evidence is sparse; therefore, we found it interesting to share our experience.

Abstract

We report a history of a patient with difficult-to-control high blood pressure, central nervous system mass and several comorbidities which altogether made the blood-lowering medication particularly challenging. Patient was diagnosed with glioblastoma, renovascular stenosis to a single kidney, and cerebral edema resulting from both cerebral tissue mass and exceedingly high systemic blood pressure. In the presented case we faced several contraindications to the guideline-recommended treatment with RAAS blockers, beta-blockers, and several diuretic classes which were determined by (1) the only remaining kidney’s renal artery stenosis, (2) decreased creatinine clearance and (3) reflex bradycardia secondary to cerebral edema. Evidence-based recommendations do not clarify all clinical aspects related to emergent high blood pressure because the evidence is sparse; therefore, we found it interesting to share our experience.

Get Citation

Keywords

secondary hypertension; renovascular hypertension; chronic kidney disease; cerebral edema; glioblastoma; hypertensive encephalopathy; hypertension emergencies

About this article
Title

Difficult-to-control secondary hypertension in a patient with history of glioblastoma, and cerebral edema — a case study

Journal

Arterial Hypertension

Issue

Vol 25, No 2 (2021)

Article type

Case report

Pages

88-91

Published online

2021-05-18

DOI

10.5603/AH.a2021.0008

Bibliographic record

Arterial Hypertension 2021;25(2):88-91.

Keywords

secondary hypertension
renovascular hypertension
chronic kidney disease
cerebral edema
glioblastoma
hypertensive encephalopathy
hypertension emergencies

Authors

Małgorzata Placek
Marta Sołtysiak
Jacek Drozdowski
Jacek Wolf

References (19)
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