A 57-year-old man comes to the physician for a follow-up appointment. Blood pressure is 190/100. He has a 20-year history of hypertension managed with hydrochlorothiazide. Two months ago at his last office visit, blood pressure was 145/90. Fundoscopic examination shows AV-nicking. A left carotid bruit is heard. Which of the following is the most likely explanation for these findings?
Addison disease
Adrenocortical hyperplasia
Conn syndrome
Pheochromocytoma
Renal artery stenosis
