Arterial Hypertension: A Vicious Circle Clinical Case

Abstract

Hypertension is an important cardiovascular risk factor and is associated with high morbidity and mortality. About 10% of patients have secondary causes and the correct diagnosis is essential for the correct management of the patient.

This is the case of a 55-year-old previously healthy man, who presents with arterial hypertension difficult to manage during hospital admission, already with established kidney and cardiac injury. The etiological investigation highlighted the regular consumption of liquorice, raising the hypothesis of a hypertension secondary to liquorice. However, the established renal and cardiac lesions could not rule out an undiagnosed essential hypertension, exacerbated by liquorice.

Given the diagnosis of hypertension in a healthy patient, the etiological study and the investigation of target organ injury are essential. The correct clinical evaluation, with an exhaustive clinical history, and raising diagnostic hypothesis with a critical spirit continue to be the pillar of a correct medical evaluation.