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The resultant rise in angiotensin <jats:styled-content style=\"fixed-case\">II<\/jats:styled-content> can lead to difficult\u2010to\u2010control blood pressure, despite normal postdissection antihypertensive agents. We highlight a case of a postdissection patient with malignant hypertension refractory to eight different enteral antihypertensives. Angiotensin\u2010converting enzyme inhibitors and angiotensin receptor blockers had been held due to postoperative acute kidney injury. A single dose of valsartan, administered on day 12, produced a marked drop in blood pressure, alleviation of encephalopathy, and allowed for cancellation of a planned tracheostomy. A serum renin level was found to be 50 times the normal upper limit. In patients with aortic dissection and renal artery involvement, angiotensin\u2010modifying agents may warrant earlier administration to combat this unique cause of hypertension.<\/jats:p>","DOI":"10.1002\/phar.2100","type":"journal-article","created":{"date-parts":[[2018,2,28]],"date-time":"2018-02-28T09:57:48Z","timestamp":1519811868000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Valsartan Effective for Malignant Hypertension after Aortic Dissection with Renal Artery Involvement"],"prefix":"10.1002","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4220-5293","authenticated-orcid":false,"given":"Christopher J.","family":"Michaud","sequence":"first","affiliation":[{"name":"Department of Pharmacy Spectrum Health Grand Rapids Michigan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brian","family":"Trethowan","sequence":"additional","affiliation":[{"name":"Department of Cardiac Anesthesia Spectrum Health Grand Rapids Michigan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,4,2]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e3182902cca"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.113.001457"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezs674"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.113.005865"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1080\/08998280.2010.11928627"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0706585"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(94)90762-5"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1161\/hc37t1.094856"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(05)67789-6"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2014.10.050"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1404731"},{"key":"e_1_2_5_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-199012000-00009"},{"key":"e_1_2_5_14_1","doi-asserted-by":"publisher","DOI":"10.1148\/95.1.73"},{"key":"e_1_2_5_15_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.288.19.2421"},{"key":"e_1_2_5_16_1","first-page":"139","article-title":"The detection of renovascular hypertension: a study of 490 patients by renal angiography","volume":"51","author":"Horvath JS","year":"1982","journal-title":"Q J Med"},{"key":"e_1_2_5_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2008.05.013"},{"key":"e_1_2_5_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1523-1755.2005.00145.x"}],"container-title":["Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fphar.2100","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/accpjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/phar.2100","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T09:54:35Z","timestamp":1761040475000},"score":1,"resource":{"primary":{"URL":"https:\/\/accpjournals.onlinelibrary.wiley.com\/doi\/10.1002\/phar.2100"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,4]]},"references-count":17,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2018,4]]}},"alternative-id":["10.1002\/phar.2100"],"URL":"https:\/\/doi.org\/10.1002\/phar.2100","archive":["Portico"],"relation":{},"ISSN":["0277-0008","1875-9114"],"issn-type":[{"type":"print","value":"0277-0008"},{"type":"electronic","value":"1875-9114"}],"subject":[],"published":{"date-parts":[[2018,4]]},"assertion":[{"value":"2018-04-02","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}