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Hypertension in the young in eastern India
1Department of Cardiology, Institute of Post-graduate Medical Education & Research, Calcutta.
Insights
Young adults with high blood pressure were studied over seven years. Renal pathology and nonspecific aortoarteritis were common causes of secondary hypertension, with angioplasty showing promising results for refractory cases.
Area of Science:
- Cardiology
- Nephrology
- Vascular Medicine
Background:
- Hypertension in young adults (18-30 years) presents unique diagnostic challenges.
- Identifying the underlying causes of secondary hypertension is crucial for effective management.
- Nonspecific aortoarteritis is an under-recognized cause of secondary hypertension and renal artery stenosis.
Purpose of the Study:
- To evaluate the causes and outcomes of hypertension in a young adult population.
- To assess the efficacy of renal angioplasty in managing refractory hypertension secondary to aortoarteritis.
- To characterize the spectrum of secondary hypertension in young individuals.
Main Methods:
- Prospective evaluation of 341 young hypertensives over a 7-year period.
- Categorization of hypertension causes: essential, renal pathology, aortoarteritis, coarctation of the aorta, endocrine.
- Intervention with renal angioplasty in 11 patients with refractory hypertension.
Main Results:
- Essential hypertension was the most frequent diagnosis (35.8%).
- Renal pathology (26.4%) and nonspecific aortoarteritis (20.1%) were the leading causes of secondary hypertension.
- Aortoarteritis was the primary cause of renal artery stenosis.
- Renal angioplasty resulted in blood pressure control without medication in 40% and improved control in 25% of patients; restenosis occurred in 4 cases within 18-24 months.
Conclusions:
- Hypertension in young adults has diverse etiologies, with renal pathology and aortoarteritis being significant contributors.
- Nonspecific aortoarteritis is a notable cause of secondary hypertension and renal artery stenosis in this age group.
- Renal angioplasty is an effective treatment for refractory hypertension in selected young patients, though restenosis requires monitoring.
Abstract:
Three hundred and forty-one young hypertensives in the age group of 18-30 years were evaluated over a 7-year period. Essential hypertension constituted the single largest group (35.8%). Renal pathology was the most common cause of secondary hypertension (26.4%). Congenital coarctation of the aorta and endocrine causes accounted for 14.1 percent and 3.2 percent cases of secondary hypertension, respectively. A strikingly high incidence of nonspecific aortoarteritis (20.1%) was a distinguishing feature amongst secondary causes. Aortoarteritis was the commonest cause of renal artery stenosis. Renal angioplasty was performed in 11 patients with refractory hypertension. Forty percent of the patients achieved post-angioplasty control of blood pressure without drugs; in 25 percent, the blood pressure became easier to control. Restenosis was detected in 4 cases over 18-24 months of follow-up.