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Adrenal Imaging in Patients with Endocrine Hypertension

Danae A Delivanis1, Dimitra-Argyro Vassiliadi2, Stylianos Tsagarakis2

  • 1Department of Endocrinology, Diabetes and Metabolism, Evangelismos Hospital, 45 Ipsilantou Street, Athens 106 76, Greece; Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, Rochester, MN, USA.

Endocrinology and Metabolism Clinics of North America
|October 28, 2019
PubMed

Insights

Hypertension, a common chronic disease, often stems from endocrine disorders. Identifying hormonal imbalances and using imaging are key to diagnosing and locating the source of secondary hypertension.

Area of Science:

  • Endocrinology
  • Cardiovascular Medicine
  • Medical Diagnostics

Background:

  • Hypertension is a prevalent chronic condition and a major risk factor for cardiovascular disease.
  • Idiopathic hypertension constitutes about 85% of cases, while secondary hypertension accounts for the remaining 15%.
  • Endocrine hypertension is a significant secondary cause, often linked to hormonal imbalances.

Purpose of the Study:

  • To outline the diagnostic approach for endocrine hypertension.
  • To emphasize the role of biochemical testing and imaging in identifying the source of hormonal excess.
  • To improve the diagnostic workup for patients with secondary hypertension.

Main Methods:

  • Biochemical confirmation of hormonal excess (mineralocorticoids, glucocorticoids, catecholamines).
  • Utilizing both functional and anatomic imaging modalities for diagnosis.
  • Systematic diagnostic workup for endocrine causes of hypertension.

Main Results:

  • Primary hyperaldosteronism, Cushing syndrome, and pheochromocytoma are the most common endocrine causes.
  • Biochemical testing is crucial for identifying specific hormonal excesses.
  • Imaging plays a vital role in localizing the source of the hormonal imbalance.

Conclusions:

  • Endocrine hypertension requires a structured diagnostic pathway involving biochemical assays and advanced imaging.
  • Accurate diagnosis and localization of the hormonal source are essential for effective management of secondary hypertension.
  • This approach aids in managing patients with elevated blood pressure due to endocrine disorders.

Keywords:
Computed tomographyCushing syndromeEndocrine hypertensionMagnetic resonance imagingPheochromocytomaPrimary aldosteronismRadionuclide imaging

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