In a case of a previously healthy 25-year-old female with elevated urine metanephrine levels, which hypertensive agent should be avoided?

In a case of a previously healthy 25-year-old female with elevated urine metanephrine levels, which hypertensive agent should be avoided?

• A. Alpha-adrenergic receptor blocker
• B. Beta-adrenergic receptor blocker
• C. Calcium channel blocker
• D. ACE-inhibitor

Answer: (B)

In the case of a previously healthy 25-year-old female with elevated urine metanephrine levels, the use of a beta-adrenergic receptor blocker should be avoided due to the potential risks associated with unopposed alpha-adrenergic receptor activity. Elevated urine metanephrines suggest the possibility of a catecholamine-secreting tumor, such as a pheochromocytoma. When beta-blockers are administered in the presence of excessive catecholamines, they can block the beta receptors and fail to counteract the effects of alpha receptor-mediated vasoconstriction. This situation can lead to increased hypertension due to the unopposed action of alpha adrenergic stimulation, which can result in severe hypertensive crises. In summary, avoiding beta-blockers is crucial in this context to prevent exacerbating hypertension caused by elevated catecholamines, thereby highlighting the importance of recognizing underlying conditions when choosing antihypertensive therapy.

In the case of a previously healthy 25-year-old female with elevated urine metanephrine levels, the use of a beta-adrenergic receptor blocker should be avoided due to the potential risks associated with unopposed alpha-adrenergic receptor activity. Elevated urine metanephrines suggest the possibility of a catecholamine-secreting tumor, such as a pheochromocytoma.

When beta-blockers are administered in the presence of excessive catecholamines, they can block the beta receptors and fail to counteract the effects of alpha receptor-mediated vasoconstriction. This situation can lead to increased hypertension due to the unopposed action of alpha adrenergic stimulation, which can result in severe hypertensive crises.

In summary, avoiding beta-blockers is crucial in this context to prevent exacerbating hypertension caused by elevated catecholamines, thereby highlighting the importance of recognizing underlying conditions when choosing antihypertensive therapy.