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In November 2011, a 31-year-old female patient was referred to the Cardiology Division for uncontrolled hypertension. She had been hospitalized for a urinary tract infection. Her systolic blood pressure was u003e200 mm Hg. She was obese. Her body mass index was 29 kg/m2, which is higher than the average body mass index among Korean women. She had a history of ulcerative colitis currently under remission, and she had a history of preeclampsia 3 and 5 years previously. She had 2 children. She had type 2 diabetes mellitus and was taking regular oral medication. She also had recurrent urinary tract infections. She complained of headache, nausea, vomiting, and blurred vision.Blood and urine tests were performed. Except for abnormal fasting glucose and hemoglobin A1C, most tests were within the normal range. Her thyroid function was normal, and her albumin:creatinine ratio in the urinary analysis was slightly above the reference range at 41.34. Her electrocardiagram (ECG) showed no evidence of left ventricular hypertrophy or any other abnormalities. Her left ventricular systolic function was normal and left ventricular mass index at 61.8 g/m2 was within the normal range. We consulted the Ophthalmology Division as she complained of blurred vision. Ophthalmological examination revealed no retinal abnormalities.We proceeded to follow the algorithm for resistant hypertension (Figure 1).1 The first step is to exclude white coat hypertension; second, to identify and reverse contributing factors; and third, to discontinue and minimize potential interfering factors and perform screening for secondary causes of hypertension.Figure 1. Algorithm for diagnosis of resistance hypertension. Adapted from Calhoun et al1 with permission of the publisher. Copyright © 2008, the American Heart Association. Authorization for this adaptation has been obtained both from the owner of the copyright in the original work and from the owner of copyright in the …

Case of Refractory Hypertension Controlled by Repeated Renal Denervation and Celiac Plexus Block