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was close to the cut-off point and renin remainednormal after prolonged strict drug washout, and furtherstudy of the PA demonstrated a unilateral aldosteroneproducing adenoma that was surgically removed,resulting in complete biochemical remission and partialclinical success. Another patient was diagnosed withidiopathic hyperaldosteronism combined withobstructive sleep apnoea syndrome, which couldincrease renin leading to a negative ARR, and finallyobtained a better therapeutic effect with PA-specificspironolactone as well as continuous positive airwaypressure. Patient 3, with hypokalaemia as the maincondition, was finally diagnosed with PA after exclusionof other diseases, and underwent laparoscopicadrenalectomy, with histological confirmation of analdosterone-producing adenoma. Postoperatively,patient 3 achieved complete biochemical successwithout medication. The clinical status of all threepatients was effectively managed, resulting in eithercomplete resolution or notable improvement of theirrespective conditions (4).Jos%u00e9%u2019s case aligns with existing literature, emphasizingthe pivotal role of community pharmacists in early DRPdetection, collaborative care, and the need forcomprehensive investigations in suspected resistanthypertension cases.It is important when screening whether or not apatient may have resistant hypertension, the patient%u2019sANALESRANFwww.analesranf.comHe was transferred to Granada and underwent acomplete blood test, obtaining high values of thealdosterone to renin ratio (ARR) ARR=46ng/dL, serumpotassium 3.9mEq/L, serum sodium 139mEq/L, urinesodium: 143 mEq/L. Hypoparathyroidism was detectedand due to the elevated ARR levels, an MRI scan wasperformed, showing a 2mm aldosterone-producingadenoma in the right adrenal gland.5. OUTCOMESDecember 2023: The patient is on the waiting list forsurgical treatment of the adenoma.The patient continues with the same antihypertensivetherapy until the time of surgery, after surgery the newdrug therapy will be evaluated.6. DISCUSSIONSeveral published case studies echo the importance ofcommunity pharmaciesin detecting medication-relatedproblems (DRPs) and collaborating with primary careteams.Similarly, in a case series published in 2023, onepatient had a history of resistant hypertension for manyyears and had a negative initial assessment ofsecondaryhypertension (including ARR). On re-evaluation, the ARFDetection and management of a case ofdrug-resistant hypertensionToro Ruiz A., L%u00f3pez-Carmona F., Zarzuelo MJ 213 An. R.Acad. Farm.Vol. 90. n%u00ba 2 (2024) %u00b7 pp. 211-214Jan-22 Jul-22 Jan-23 Jul-23 Dec-23Carvedilol6,25 mgCarvedilol 6,25 mg Carvedilol 25 mg Carvedilol 25 mg Carvedilol 25 mgLosartan100 mgLosartan 100 mg Losartan 100 mg Losartan 100 mg Losartan 100 mgLercanidipine 10 mgLercanidipine10 mgLercanidipine10 mgLercanidipine 10 mgDoxazosin 4 mg Doxazosin 4 mg Doxazosin 4 mg Doxazosin 4 mgFolic acid/b12 Folic acid/b12 Folic acid/b12Allopurinol 100mg Allopurinol 100 mgParicalcitol 1mg Paricalcitol 1 mgAtorvastatin 40 mgAcetylsalicylic acid 100 mgPrednisone 5-10-30 startsprednisone regimen 6monthsTable 1. Treatment evolution