Uncontrolled Hypertension in an Elderly Man on Multiple Antihypertensive Drugs

The evaluation of uncontrolled hypertension includes the determination of whether the criteria for resistant hypertension are met which includes ruling out pseudoresistant hypertension. This may uncover significant nonadherence which is a common cause of uncontrolled hypertension. Even when resistant hypertension is not present, the principles of evaluation of this disorder are helpful in many cases of uncontrolled hypertension and will assist with management. The evaluation may identify potential contributing factors of uncontrolled hypertension including newer medications for which hypertension is a common side effect. Posaconazole may cause amineralocorticoid-excess syndrome with hypertension and hypokalemia. Ibrutinib may also lead to worsening hypertension through various mechanisms.