In a patient with markedly elevated blood pressure that is resistant to treatment, what secondary cause of hypertension should be considered based on a metabolic panel?

When evaluating a patient with resistant hypertension, hyperaldosteronism stands out as a significant secondary cause. This condition, also known as primary hyperaldosteronism or Conn's syndrome, is characterized by excessive production of the hormone aldosterone from the adrenal glands. Elevated levels of aldosterone lead to increased sodium reabsorption in the kidneys, resulting in increased fluid retention, elevated blood volume, and ultimately higher blood pressure.

The metabolic panel can provide vital clues indicating the presence of hyperaldosteronism. Typically, one would see low levels of potassium (hypokalemia) due to the aldosterone's role in promoting potassium excretion. These findings, coupled with resistant hypertension, point toward hyperaldosteronism as a likely underlying cause.

In contrast, chronic kidney disease may contribute to hypertension but does not typically bring about the specific electrolyte changes observed with hyperaldosteronism. Acute renal failure can cause secondary hypertension, but it usually presents with more acute symptoms or changes in renal function. Pheochromocytoma may lead to episodes of hypertension and is typically associated with other symptoms such as palpitations, pallor, and sweating due to catecholamine release; however, it doesn't have the same distinct laboratory profile as