Abstract Body: Introduction
Hypertension in young adults without comorbidities or family history often prompts evaluation for secondary causes. Thorough and repeated history-taking is key. This case highlights an overlooked dietary factor contributing to elevated blood pressure, initially misattributed to resistant hypertension.
Hypothesis
Modifiable lifestyle factors, including routine electrolyte supplement use, may lead to reversible hypertension in young adults and should be considered early in the diagnostic process.
Methods
A 30-year-old female radiation therapist presented with recent-onset hypertension and symptoms of dizziness, head pressure, and palpitations. At her initial visit, systolic blood pressure (SBP) was in the 180s, and she was started on amlodipine. On follow-up, SBP decreased to the 150s, but symptoms persisted, and carvedilol was added. Despite dual therapy, SBP remained in the 140s with ongoing headaches. She was being considered for a third antihypertensive and labeled as having possible resistant hypertension.
At that visit, a more detailed dietary history revealed she had been taking an electrolyte powder mixed with water 1–2 times daily for fatigue — a regimen she began around the time of her diagnosis. This detail had been omitted in multiple prior visits despite repeated dietary and lifestyle questions.
Workup including renal panel, thyroid function, renal ultrasound, brain MRI/MRA, echocardiography, and Holter monitoring was unremarkable.
Results
After stopping the electrolyte powder, her symptoms resolved and blood pressure normalized. Antihypertensive medications were tapered and discontinued. At follow-up, she remained normotensive and asymptomatic.
Conclusions
This case underscores the value of repeated and detailed history-taking in young patients with new-onset hypertension. Lifestyle factors like electrolyte supplements, often overlooked, can contribute to significant blood pressure elevation and mimic resistant hypertension. Identifying such triggers can prevent unnecessary treatments and diagnostics