Secondary causes of hypertension.

Secondary hypertension is the presence of a specific condition known to cause hypertension, which may be the primary cause or a contributing factor in a patient who already has primary hypertension. Although uncommon, it may cause major morbidity for a subset of patients. This article provides an overview of the range of secondary causes, including key clinical features and appropriate diagnostic and treatment options. Selection of patients for testing should incorporate historical and clinical clues, previous treatment course, and comorbidities. Decisions regarding the extent of secondary evaluation require consideration of the likelihood of diagnosis, the patient's overall health status and prognosis, and balancing the risks of intervention against the risks of missing a diagnosis. Referral is advised when these risks seem prohibitive or if there are questions regarding the selection of the most optimal studies or the extent of intervention to pursue when blood pressure remains uncontrolled.

[1]  T. Young,et al.  Prospective study of the association between sleep-disordered breathing and hypertension. , 2000, The New England journal of medicine.

[2]  V. Somers,et al.  Nocturnal continuous positive airway pressure decreases daytime sympathetic traffic in obstructive sleep apnea. , 1999, Circulation.

[3]  W. Young,et al.  A comparison of biochemical tests for pheochromocytoma: measurement of fractionated plasma metanephrines compared with the combination of 24-hour urinary metanephrines and catecholamines. , 2003, The Journal of clinical endocrinology and metabolism.

[4]  S. Textor,et al.  Resistant Hypertension: Comparing Hemodynamic Management to Specialist Care , 2002, Hypertension.

[5]  H. Barros Accuracy of twenty‐four‐hour ambulatory blood pressure monitoring (night–day values) for the diagnosis of secondary hypertension , 1995, Journal of hypertension.

[6]  K. Bailey,et al.  Blood pressure load--a better determinant of hypertension. , 1988, Mayo Clinic proceedings.

[7]  P. Torjesen,et al.  Low-renin status in therapy-resistant hypertension: a clue to efficient treatment , 2004, Journal of hypertension.

[8]  D. Calhoun,et al.  Plasma aldosterone is related to severity of obstructive sleep apnea in subjects with resistant hypertension. , 2007, Chest.

[9]  H. Black,et al.  Resistant hypertension in a tertiary care clinic. , 1991, Archives of internal medicine.

[10]  T. MacDonald,et al.  Is aldosterone the missing link in refractory hypertension?: aldosterone-to-renin ratio as a marker of inappropriate aldosterone activity , 2002, Journal of Human Hypertension.

[11]  F. Fuchs,et al.  Obstructive sleep apnea and resistant hypertension: a case-control study. , 2007, Chest.

[12]  E. Boerwinkle,et al.  Validity of the aldosterone-renin ratio used to screen for primary aldosteronism. , 2001, Mayo Clinic proceedings.

[13]  T. Goodfriend,et al.  Resistant hypertension, obesity, sleep apnea, and aldosterone: theory and therapy. , 2004, Hypertension.

[14]  K. Tsuchiya,et al.  Variability in the renin/aldosterone profile under random and standardized sampling conditions in primary aldosteronism. , 2003, The Journal of clinical endocrinology and metabolism.

[15]  T. Grobner Gadolinium--a specific trigger for the development of nephrogenic fibrosing dermopathy and nephrogenic systemic fibrosis? , 2006, Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association.

[16]  D. Goff,et al.  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. , 2008, Circulation.

[17]  S. Textor Renovascular hypertension in 2007: Where are we now? , 2007, Current cardiology reports.

[18]  T. Grobner,et al.  Gadolinium and nephrogenic systemic fibrosis. , 2007, Kidney international.

[19]  R. D'Agostino,et al.  Stent revascularization for the prevention of cardiovascular and renal events among patients with renal artery stenosis and systolic hypertension: rationale and design of the CORAL trial. , 2006, American heart journal.

[20]  G. Eknoyan,et al.  National Kidney Foundation Practice Guidelines for Chronic Kidney Disease: Evaluation, Classification, and Stratification , 2003, Annals of Internal Medicine.

[21]  Daniel W. Jones,et al.  The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. , 2003, JAMA.

[22]  Thomas Penzel,et al.  Effect of Nasal Continuous Positive Airway Pressure Treatment on Blood Pressure in Patients With Obstructive Sleep Apnea , 2003, Circulation.

[23]  M. Walther,et al.  Biochemical diagnosis of pheochromocytoma: which test is best? , 2002, JAMA.

[24]  H. Black,et al.  Resistant hypertension revisited: a comparison of two university-based cohorts. , 2005, American journal of hypertension.

[25]  F. Abboud,et al.  Sympathetic neural mechanisms in obstructive sleep apnea. , 1995, The Journal of clinical investigation.

[26]  S. Textor,et al.  Renal-artery stenosis. , 2001, The New England journal of medicine.

[27]  D. Calhoun,et al.  Hyperaldosteronism Among Black and White Subjects With Resistant Hypertension , 2002, Hypertension.

[28]  M. Brown,et al.  Is resistant hypertension really resistant? , 2001, American journal of hypertension.

[29]  W Zidek,et al.  Prevention of radiographic-contrast-agent-induced reductions in renal function by acetylcysteine. , 2000, The New England journal of medicine.

[30]  D. Grobbee,et al.  High Prevalence of Secondary Hypertension and Insulin Resistance in Patients with Refractory Hypertension , 2003, Blood pressure.