A 5 6 , 210 lb., 64-year-old male business executive had a physical exam prior to his retirement from corporate work. His blood pressure was 180/115 on three separate days. Further examination showed normal to low plasma renin activity, elevated total peripheral resistance (TPR), cardiac output (CO) of 7.2 L/min, x-ray evidence of left ventricular hypertrophy , retinal hemorrhages, and mild polyuria. Recommended therapy was weight reduction to his ideal level, a low-salt diet ( 2 gm/day sodium), prudent exercise, and a reduction in alcohol consumption ( 3 oz whiskey/day). This change in lifestyle did little to change the condition. Medication was initiated in the form of an oral diuretic and progressed to a beta-blocker; eventually a vasodilator was included to reduce the blood pressure to 140/90.