Rare Hormonal Cause Behind Resistant Hypertension Diagnosed at Wockhardt Hospitals
Mumbai: A 44-year-old working professional, struggling with uncontrolled blood pressure for over a decade, finally found relief at Wockhardt Hospitals, Mumbai Central, after doctors uncovered a rare hormonal cause behind his condition.
The patient arrived with severe headaches, dizziness, and dangerously high blood pressure of 170/110 mmHg, despite being on multiple medications.
“In young patients with uncontrolled or resistant blood pressure, we always consider secondary causes like hormonal imbalances or obstructive sleep apnea. His sleep study (polysomnography) did reveal obstructive sleep apnea, which often contributes to hypertension.
However, his blood pressure levels were disproportionately high, prompting us to evaluate further,” explained Dr Prashant Makhija, Consultant Neurologist.
This led to a hormonal work-up under Dr Pranav Ghody, Consultant Endocrinologist. His borderline low potassium levels and biochemical profile pointed towards primary aldosteronism, a condition where excess aldosterone from the adrenal glands drives hypertension.
An MRI showed a small nodule on the right adrenal gland, but that alone wasn’t enough to decide on surgery,” he said. To confirm, Dr Dharav Kheradia, Consultant Neuro & Vascular Interventional Radiologist, performed a specialised adrenal vein sampling procedure, which measures hormone levels directly from both adrenal glands.
“It’s a technically demanding test, but crucial. In this case, both glands were overproducing aldosterone, meaning surgery would not have helped,” he noted. With the correct diagnosis, the patient was spared unnecessary surgery and placed on tailored medical therapy, alongside treatment for sleep apnea.
“The key learning is that secondary causes of hypertension are not as rare as once believed. In fact, in patients who have been diagnosed with hypertension at an early age (before age of 40 years) or require multiple medicines to control blood pressure, a hormonal cause can be found in as many as 30% of the cases.
In these cases, timely evaluation and advanced tests like adrenal vein sampling can transform outcomes,” added Dr Ghody. This case underscores Wockhardt Hospitals’ comprehensive, multi-disciplinary approach, ensuring patients receive the right treatment, not just the obvious one.
Khushi Chittoria joined Medical Dialogues in 2025 as a Media and Editorial Intern. She holds a Bachelor degree in Bachelor of Arts degree in Journalism and Mass Communication from IP University and has completed certifications in content writing. She has a strong interest in anchoring, content writing, and editing. At Medical Dialogues, Khushi manages the editorial department, web stories and anchoring.