In a patient with hypertension resistant to multiple medications, what causes elevated blood pressure despite reduced angiotensin II levels after administration of an ACE inhibitor?

💡 Explanation

Autonomous aldosterone production results in continued sodium and water retention, leading to sustained hypertension despite ACE inhibition, because the angiotensin II-dependent pathway is bypassed; therefore, elevated blood pressure persists rather than being reduced by angiotensin II blockade.

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