Severe Resistant Hypertension Induced by Carbamazepine in an Elderly Patient

Kim, Seon Jae; Koh, Jung A; Lee, Hak Chul; Kim, Si Eun; Chu, Seong Taek; Lee, Seung Hun; Sir, Jung Ju; Choi, Seung Min; Joo, Shin Bae; Lee, Hong Soon; Han, Dae Hee

doi:2013.17.2.99

Ann Geriatr Med Res > Volume 17(2); 2013 > Article

Case Report

Journal of the Korean Geriatrics Society 2013;17(2):99-102.
DOI: https://doi.org/10.4235/jkgs.2013.17.2.99 Published online June 30, 2013.

Severe Resistant Hypertension Induced by Carbamazepine in an Elderly Patient

Seon Jae Kim, Jung A Koh, Hak Chul Lee, Si Eun Kim, Seong Taek Chu, Seung Hun Lee, Jung Ju Sir, Seung Min Choi, Shin Bae Joo, Hong Soon Lee, Dae Hee Han

¹Department of Internal Medicine, National Medical Center, Seoul, Korea. seo0515@medimail.co.kr
²Department of Cardiovascular Center, National Medical Center, Seoul, Korea.
³Department of Neurosurgery, National Medical Center, Seoul, Korea.

노인 환자에서 carbamazepine에 의해 발생한 저항성 고혈압 1례

김선재^1,2·고정아^1,2·이학철^1,2·김시은^1,2·주성택^1,2·이희숙^1,3·이승훈^1,2·서정주^1,2·최승민^1,2·주신배^1,2 이홍순^1,2·한대희³

국립중앙의료원 순환기내과¹, 심혈관센터², 신경외과³

Abstract

We report a case of a 73-year-old patient with a 17 year-history of well-controlled primary hypertension with a single antihypertensive drug, which became uncontrolled since 9 months ago when he started on oral carbamazepine (CBZ) therapy for syringomyelia. On admission, the patient had a blood pressure of 200-215/95-104mmHg despite an antihypertensive combination therapy with five different drugs. Further investigations ruled out secondary hypertension such as primary aldosteronism, pheochromocytoma and renal artery stenosis. After the discontinuation of CBZ, the blood pressure profile became significantly improved. The rechallenge with CBZ aggravated his blood pressure profile. Therefore, we considered that resistant hypertension was induced by the oral CBZ therapy.

Key Words: Carbamazepine, Hypertension, Tricyclic antidepressants