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Prevalence and Risk Factors for Secondary Hypertension in Young Adults
Jean-Baptiste de Freminville1,2, Margherita Gardini1, Antoine Cremer3
1Hypertension Unit (J.-B.d.F., M.G., S.C., G.B., N.G., A.L., C.M., A.-M.M., J.R., N.P.-V., M.A., L.A.), Hôpital Européen Georges Pompidou, AP-HP, Université Paris Cité, France.
Hypertension (Dallas, Tex. : 1979)
|September 19, 2024
Summary
Secondary hypertension (2HTN) affects nearly 30% of young adults with hypertension. Screening for secondary causes is recommended for all hypertensive patients under 40, regardless of blood pressure or age.
Area of Science:
- Cardiology
- Nephrology
- Endocrinology
Background:
- The prevalence of secondary causes of hypertension in young adults remains largely unknown.
- Lack of consensus exists regarding the necessity of screening for secondary hypertension (2HTN) in this demographic.
- This study aimed to determine the prevalence and identify the causes of 2HTN in young individuals.
Purpose of the Study:
- To investigate the prevalence of secondary hypertension (2HTN) in young adults.
- To identify the common etiological factors contributing to 2HTN in this population.
- To provide evidence-based recommendations for screening protocols.
Main Methods:
- A cross-sectional study included 2090 patients aged 18–40 with confirmed hypertension.
- Comprehensive workup for secondary hypertension screening was performed on all participants.
- Prevalence of 2HTN and associated factors were analyzed.
Main Results:
- A significant prevalence of 2HTN was found in 29.6% of young hypertensive patients.
- Primary aldosteronism (54.8%) was the leading cause, followed by renovascular hypertension (18.4%) and primary kidney disease (12.9%).
- Factors associated with higher 2HTN prevalence included female sex, hypokalemia, polypharmacy, lean body mass index, and diabetes.
Conclusions:
- Secondary hypertension is highly prevalent in young hypertensive patients (29.6%), irrespective of age or blood pressure levels.
- Screening for secondary causes of hypertension is strongly recommended for all individuals under 40.
- Early identification and management of secondary hypertension are crucial in this age group.
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