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3. ASSESMENTAccording to the guidelines of the Spanish Society ofNephrology, if resistant hypertension is suspected, aself-measurement of blood pressure (SMBP) isperformed (Figure 1).In the SMBP data we can see that blood pressure isslightly high throughout the day (SBP = 145 mmHg, DBP=8 5 mmHg; Heart rate = 87beats/min), with peaks ofSBP =1 51 mmHg, DBP = 87 mmHg, Heart rate = 87beats/min, with several drops in blood pressure notassociated with the hours of taking medication (SB P=102 mmHg; DBP = 58 mmHg; Heart rate = 75beats/min). It wastherefore decided to refer the patientto his PCP by means of a referral letter with suspicion ofprimary hyperaldosteronism, a frequent cause ofsecondary hypertension and resistant hypertension,which entails an increase in vascular risk and organdamage related to both blood pressure and aldosteronelevels (1).4. TREATMENTTherefore, a new blood test with aldosterone, calcium,sodium and potassium levelsisrecommended to his PCP(3).June 2023: The patient went to the coast for asummer holiday, where he suffered an episode ofhypotension and lost consciousness for a few seconds.1. BACKGROUNDPatients visit the pharmacy many more times per yearthan their primary care physicians (PCP), with thecommunity pharmacist having much more patient caretime than their own PCP. This makes it easier for thecommunity pharmacy team to detect medicationrelated problems (DRP), and through collaborativepractice with the primary care team, any DRP that mayarise can be addressed earlier.2. CASE PRESENTATIONJos%u00e9, 82 years old, weight 87 kg, height 179 cm, nonregular customer of the pharmacy until 2023, diagnosedwith hypertension in 2002, no other pathology. He doesnot smoke, drinks occasionally, does moderate physicalexercise (walking) for 6-10 hours a week. He has nofamily history of hypertension, although he does havediabetes and inherited familial hypercholesterolemia.His blood pressure has been within range for quite sometime, but he told us that since the summer of 2022 hisblood pressure had risen and it was not enough with themedication he was taking at the time, adding his PCPlercanidipine 10 mg and doxazosin 4 mg (Table 1).Afterseveral monthsin which the patient told usthathe was not feeling well, we assessed his compliance withtreatment, concluding that the patient was taking hismedication correctly.212ANALESRANFwww.analesranf.comDetecci%u00f3n y manejo de un caso de hipertensi%u00f3nfarmacorresistenteToro Ruiz A., L%u00f3pez-Carmona F., Zarzuelo MJAn. R.Acad. Farm.Vol. 90. n%u00ba 2 (2024) %u00b7 pp. 211-214Figure 1. Diagnostic and therapeutic process of resistant hypertension (2)