Hypertension uncontrolled on three drugs — CCE clinical encounter

Objectives

1. Recognise that a single raised reading on treatment requires structured assessment, not reflex escalation. ^[3]
2. Establish the true pressure burden with out-of-office measurement before changing therapy. ^{[2] [4]}
3. Identify pseudo-resistance — nonadherence signalled by dispensing gaps — and address it without shaming the patient. ^[11]
4. Screen selectively for secondary causes, including primary aldosteronism given the family history and resistant pattern. ^{[10] [6]}
5. Agree a follow-up plan with named monitoring after any change. ^[11]