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The prevalence of secondary and curable hypertension
Insights
This study found that secondary hypertension is rare, affecting less than 5% of patients. However, a portion of these cases are curable with targeted treatment, highlighting the importance of thorough investigation for difficult-to-treat hypertension.
Area of Science:
- Nephrology
- Endocrinology
- Cardiovascular Medicine
Background:
- Secondary hypertension, often linked to underlying conditions, presents a diagnostic challenge.
- Identifying curable causes of hypertension is crucial for effective patient management.
Purpose of the Study:
- To determine the prevalence of secondary and curable hypertension in a patient cohort.
- To evaluate the effectiveness of treating underlying causes of secondary hypertension.
Main Methods:
- Retrospective analysis of 1000 patients diagnosed with hypertension.
- Categorization of secondary hypertension based on underlying etiological factors.
- Assessment of treatment outcomes following intervention for the identified causes.
Main Results:
- 47 out of 1000 patients (4.7%) exhibited secondary hypertension.
- Renoparenchymal disease (21 patients) and endocrine hypertension (13 patients) were the most common causes.
- Blood pressure normalized in 11 patients and improved in 7 after treatment of the underlying condition.
Conclusions:
- Secondary hypertension is uncommon, with curable forms being even rarer.
- Basic diagnostic methods are often sufficient for identifying secondary hypertension.
- Further investigation, particularly for renal artery stenosis, is warranted in specific patient groups, including young individuals and those with resistant hypertension.
Abstract:
The prevalence of secondary and curable hypertension was studied retrospectively in 1000 patients. The concept of "secondary hypertension" was used when hypertension was combined with a disease which may have affected the individual's blood pressure. When this definition was applied, 47 of the patients displayed some form of secondary hypertension: stenosis of the renal artery in 10, renoparenchymal disease in 21, hydronephrosis in 3, and endocrine hypertension in 13 (8 of the latter were using oral contraceptives). The blood pressure normalized in 11 and improved in 7 of these patients after operative treatment of the underlying disease or, when appropriate, discontinuance of intake of contraceptive pills. The incidence of secondary hypertension in this and other series is low, and the number of patients with curable hypertension is even lower. In the majority of cases, secondary hypertension can be diagnosed by anamnesis, physical examination and simple tests of blood and urine. If this basic investigation can be extended, the incidence of stenosis of the renal artery should be examined in the first place. Hypertension in young patient and in patients who are difficult to treat often justifies a more extensive investigation.