Secondary hypertension

Question 1

What % of hypertesnion is secondary ?

Answer 1

10%

Question 2

When should you consider hypertension ?

Answer 2

Severe or resistant hypertension
Child/ adolescent
Worsening of previously stable hypertension
Malignant hypertension
No other risk factors identified and ages <30

Question 3

What are the investigations of secondary hypertension ?

Answer 3

Renal function and urinalysis 
Renal imaging
Aldosterone to renin ratio 
24hr urine for catecholamines/ metanephrines looking for pheochromocytoma or paraganglioma 
    - only if clinical suspicion

Question 4

How can renal disease cause secondary hypertension ?

Answer 4

20% resistant hypertension 
Chronic pyelonephritis 
Fibromuscular dysplasia FMD
Renal artery stenosis 
Polycystic kidneys

Question 5

What causes drug induced secondary hypertension ?

Answer 5

NSAIDs
Combined oral contraceptive
Corticosteroids
Cocaine and other stimulants

Question 6

How can pregnancy cause secondary hypertension ?

Answer 6

Gestational hypertension

Pre-eclampsia

Question 7

What endocrine disorders can cause secondary hypertension ?

Answer 7

Primary hyperaldosteronism
Chushings syndrome
Pheochromocytoma
Hypo/hyperthyroidism

Question 8

What vascular disorders can cause hypertension ?

Answer 8

Coarctation of the aorta