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Factors predicting secondary hypertension in young adults with hypertension: a retrospective study
Nicha Prasert1, Worapaka Manosroi2,3,4, Benya Hankamolsiri1
1Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
Insights
Identifying secondary hypertension in young adults can be challenging. This study found that being female, high systolic blood pressure, and low serum potassium are key indicators of secondary hypertension in this age group.
Area of Science:
- Cardiology
- Endocrinology
- Nephrology
Background:
- Investigating secondary causes of hypertension in young adults is resource-intensive.
- This study focused on identifying predictive markers for secondary hypertension in individuals under 40.
Purpose of the Study:
- To identify clinical and biochemical markers suggestive of secondary hypertension in young adults.
- To aid in the efficient diagnosis of secondary hypertension in this demographic.
Main Methods:
- A 6-year retrospective observational cohort study of 207 young adults with hypertension.
- Assessed for secondary causes including primary aldosteronism and hyperthyroidism.
- Utilized multivariable logistic regression to identify significant predictors (p < 0.05).
Main Results:
- Secondary hypertension was diagnosed in 3.4% of patients.
- Primary aldosteronism and hyperthyroidism were the most common secondary causes.
- Significant predictors identified: female sex (OR 4.56), systolic blood pressure > 160 mmHg (OR 1.44), and serum potassium < 3.5 mEq/L (OR 3.69).
Conclusions:
- Easy-to-obtain clinical and biochemical markers can help identify secondary hypertension in young adults.
- Absence of these predictors may indicate a lower likelihood of secondary hypertension.
- Markers should supplement, not replace, thorough clinical assessment for diagnosis.
Background:
Hypertension in young adults is often due to secondary causes, and investigating these can be resource-intensive. This study aimed to identify clinical and biochemical markers that could suggest secondary hypertension in individuals under 40 years.
Materials And Methods:
A 6-year retrospective observational cohort study included 207 young adults with hypertension who were assessed for secondary causes such as hyperthyroidism, primary aldosteronism, Cushing's syndrome, pheochromocytoma, and renovascular disease. Multivariable logistic regression was used to identify significant predictors, with a significance level set at p < 0.05.
Results:
Secondary hypertension was diagnosed in 7 patients (3.4%). The most common diagnoses were primary aldosteronism and hyperthyroidism. Three significant clinical and biochemical predictors were identified: female (OR 4.56, p = 0.020), systolic blood pressure > 160 mmHg at the time of diagnosis (OR 1.44, p = 0.010), and serum potassium < 3.5 mEq/L (OR 3.69, p = 0.019).
Conclusion:
Several easy-to-obtain clinical and biochemical markers can help identify secondary hypertension in young adults. Individuals who do not have any of these predictors may have a lower likelihood of secondary hypertension; however, these markers should always be used in conjunction with a thorough clinical assessment and are not intended to serve as definitive criteria for diagnosis.
Clinical Trial Number:
Not applicable.
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