Secondary hypertension

Question 1

secondary hypertension is common or uncommon

Answer 1

common, single biggest contributor to the global burden of disease, accounts for about 10% of all hypertension and has an identifiable cause. incidence is highest in youngest patients

Question 2

consider secondary hypertension if

Answer 2

severe or resistant hypertension, child, worsening or previously stable hypertension, malignant hypertension, no other risk factors identified and age less than 30

Question 3

investigations

Answer 3

renal function and urinalysis, renal imaging eg US and MRA renal arteries, aldosterone to renin ratio, 24h urine for catecholamines/ metanephrines looking for a phaechromocytoma or paraganglioma

Question 4

causes for secondary hypertension

Answer 4

renal disease , drug induced, pregnancy, endocrine, vascular, sleep apnoea

Question 5

drugs that could cause hypertension

Answer 5

NSAIDs, combined oral contraceptive, corticosteroids, cocaine and other stimulants

Question 6

phaechromocytoma

Answer 6

patients present with accelerated hypertension, resistant hypertension and headaches, flushing, sweating, palpitations. genetic predisposition. essential to involve MDT of endocrinologists and surgeons