Diagnostic of secondary hypertension in clinical practice

Czech version

Authors: Z. Šomlóová; J. Rosa; O. Petrák; B. Štrauch; T. Zelinka; R. Holaj; J. Widimský jr.
Authors‘ workplace: III. interní klinika 1. lékařské fakulty UK a VFN Praha, přednosta prof. MUDr. Štěpán Svačina, DrSc., MBA
Published in: Vnitř Lék 2011; 57(9): 772-776
Category: 65th birthday Mudr. Jany Laciné and and 60th birthday Milana Tržila

Overview

Arterial hypertension is a common worldwide disease with a prevalence of approximately 26%. Secondary cause is known in 5–10% of patients with hypertension. We should think of secondary hypertension in all patients with resistant hypertension, in patients with sudden deterioration in the control of hypertension and in patients with laboratory and clinical signs of diseases associated with secondary hypertension. It is important to distinguish between secondary hypertension and pseudo-resistance (noncompliance to treatment, white coat syndrome). Secondary causes of hypertension can be divided into endocrine (primary aldosteronism, pheochromocytoma, hypercortisolism, hyperparathyreoidism), renal – renovascular and renal parenchymal hypertension, and other causes as sleep apnoe syndrome, hypertension in pregnancy, coarctation of the aorta and intracranial tumors.

Key words:
secondary hypertension – primary aldosteronism – renovascular and renal parenchymal hypertension – pheochromocytoma – hypercortisolism – sleep apnoe syndrome – hypertension in pregnancy – coarctation of the aorta

Sources

1. Kearney PM, Whelton M, Reynolds K et al. Global burden of hypertension: analysis of worldwide data. Lancet 2005; 365: 217–223.

2. Widimský J. Hypertenze. 3. vyd. Praha: Triton 2008.

3. Mancia G, De Backer G, Dominiczak A et al. ESH-ESC Task Force on the Management of Arterial Hypertension. 2007 ESH-ESC Practice Guidelines for the Management of Arterial Hypertension: ESH-ESC Task Force on the Management of Arterial Hypertension. J Hypertens 2007; 25: 1751–1762.

4. Brown MA, Buddle ML, Martin A. Is resistant hypertension really resistant? Am J Hypertens 2001; 14: 1263–1269.

5. Hermida RC, Ayala DE, Calvo C et al. Effects of time of day of treatment on ambulatory blood pressure pattern of patients with resistant hypertension. Hypertension 2005; 46: 1053–1059.

6. Calhoun DA, Jones D, Textor S et al. American Heart Association Professional Education Committee. Resistant hypertension: diagnosis, evaluation, and treatment: a scientific statement from the American Heart Association Professional Education Committee of the Council for High Blood Pressure Research. Circulation 2008; 117: e510–e526.

7. Young WF. Primary aldosteronism: renaissance of a syndrome. Clin Endocrinol (Oxf) 2007; 66: 607–618.

8. Štrauch B, Zelinka T, Hampf M et al. Prevalence of primary hyperaldosteronism in moderate to severe hypertension in the Central Europe region. J Hum Hypertens 2003; 17: 349–352.

9. Milliez P, Girerd X, Plouin PF et al. Evidence for an increased rate of cardiovascular events in patients with primary aldosteronism. J Am Coll Cardiol 2005; 45: 1243–1248.

10. Rossi GP, Bernini G, Desideri G et al. PAPY Study Participants. Renal damage in primary aldosteronism: results of the PAPY Study. Hypertension 2006; 48: 232–238.

11. Tanabe A, Naruse M, Naruse K et al. Left ventricular hypertrophy is more prominent in patients with primary aldosteronism than in patients with other types of secondary hypertension. Hypertens Res 1997; 20: 85–90.

12. Fallo F, Veglio F, Bertello C et al. Prevalence and Characteristics of the Metabolic Syndrome in Primary Aldosteronism. J Clin Endocrinol Metab 2006; 91: 454–459.

13. Strauch B, Petrák O, Wichterle D et al. Increased arterial wall stiffness in primary aldosteronism in comparison with essential hypertension. Am J Hypertens 2006; 19: 909–914.

14. Holaj R, Zelinka T, Wichterle D et al. Increased intima-media thickness of the common carotid artery in primary aldosteronism in comparison with essential hypertension. J Hypertens 2007; 25: 1451–1457.

15. Young WF Jr, Klee GG. Primary aldosteronism. Diagnostic evaluation. Endocrinol Metab Clin North Am 1988; 17: 367–395.

16. Widimský J jr. Sekundární hypertenze. 1. vyd. Praha: Triton 2003.

17. Funder JW, Carey RM, Fardella C et al. Endocrine Society. Case detection, diagnosis, and treatment of patients with primary aldosteronism: an endocrine society clinical practice guideline. J Clin Endocrinol Metab 2008; 93: 3266–3281.

18. Celen O, O’Brien MJ, Melby JC et al. Factors influencing outcome of surgery for primary aldosteronism. Arch Surg 1996; 131: 646–650.

19. Lumachi F, Ermani M, Basso SM et al. Long-term results of adrenalectomy in patients with aldosterone-producing adenomas: multivariate analysis of factors affecting unresolved hypertension and review of the literature. Am Surg 2005; 71: 864–869.

20. Monhart V. Hypertenze a ledviny. Praha: Triton 2004.

21. Buckalew VM Jr, Berg RL, Wang SR et al. Prevalence of hypertension in 1,795 subjects with chronic renal disease: the modification of diet in renal disease study baseline cohort. Modification of Diet in Renal Disease Study Group. Am J Kidney Dis 1996; 28: 811–821.

22. Conlon PJ, O’Riordan E, Kalra PA. New insights into the epidemiologic and clinical manifestations of atherosclerotic renovascular disease. Am J Kidney Dis 2000; 35: 573–587.

23. Aqel RA, Zoghbi GJ, Baldwin SA et al. Prevalence of renal artery stenosis in high-risk veterans referred to cardiac catheterization. J Hypertens 2003; 21: 1157–1162.

24. Hackam DG, Spence JD, Garg AX et al. Role of renin-angiotensin system blockade in atherosclerotic renal artery stenosis and renovascular hypertension. Hypertension 2007; 50: 998–1003.

25. Somers VK, White DP, Amin R et al. American Heart Association Council for High Blood Pressure Research Professional Education Committee, Council on Clinical Cardiology; American Heart Association Stroke Council; American Heart Association Council on Cardiovascular Nursing; American College of Cardiology Foundation. Sleep Apnea and Cardiovascular Disease: An American Heart Association//American College of Cardiology Foundation Scientific Statement From the American Heart Association Council for High Blood Pressure Research Professional Education Committee, Council on Clinical Cardiology, Stroke Council, and Council on Cardiovascular Nursing In Collaboration With the National Heart, Lung, and Blood Institute National Center on Sleep Disorders Research (National Institutes of Health). Circulation 2008; 118: 1080–1111.