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Screening hypertensive patients for surgically reversible causes--unsettled issues.

H Yamauchi

    Heart & Lung : the Journal of Critical Care
    |March 1, 1981
    PubMed
    Summary

    The exact frequency of surgically reversible hypertension in the general population remains unknown. Current screening tests are limited, and medical therapy is a viable option for specific conditions like aldosterone adenomas.

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    Area of Science:

    • Nephrology
    • Endocrinology
    • Cardiovascular Medicine

    Background:

    • The prevalence of surgically remediable hypertension in unselected hypertensive individuals is not well-established.
    • Existing studies on surgical hypertension frequency often originate from specialized referral centers, potentially skewing results.

    Purpose of the Study:

    • To address the lack of established data on the frequency of surgically reversible hypertension in the general hypertensive population.
    • To highlight the need for future surveys to differentiate between the incidence of surgically remediable hypertension and the number of patients actually undergoing surgical intervention.

    Main Methods:

    • Review of existing literature on the frequency of surgically remediable hypertension.
    • Analysis of current screening test efficacy for conditions like aldosterone adenomas and renal artery stenosis.

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  • Evaluation of medical versus surgical therapeutic options for specific hypertensive conditions.

    • Main Results:

    • The true frequency of surgically reversible hypertension in the general population is currently unknown.
    • A significant discrepancy likely exists between the incidence of surgically remediable hypertension and the number of patients receiving surgical treatment.
    • Most current screening tests for surgical hypertension lack the necessary criteria for widespread application, with serum potassium being a notable exception for aldosterone adenomas.

    Conclusions:

    • Medical therapy is a suitable alternative for selected aldosterone adenoma cases and the preferred treatment for certain instances of renal artery stenosis.
    • Further research is required to accurately determine the prevalence of surgically remediable hypertension and the proportion of patients receiving surgical intervention.