22nd June 2026

A 48-year-old gentleman is being investigated in the ambulatory care unit for resistant hypertension.

A 48-year-old gentleman is being investigated in the ambulatory care unit for resistant hypertension. He has a panel of investigations, which are shown below:

Aldosterone/renin ratio: 20 [0-30 ng/dL per ng/mL/hr]

TSH 0.6 [0.5 to 5.0 mIU/L]

T4 0.8 [0.7 to 1.9ng/dL]

Urinary cortisol 85 [<120 nmol/24 hour]

Urinary metanephrines 800 μg/24 hours

How do you treat this patient’s resistant hypertension?

Select the SINGLE most appropriate option from the list below. Select ONE option only.