Thursday, September 18, 2008

Tangents: Secondary Hypertension

Tangents: Secondary Hypertension:

"Who are we worried about?
1. severe hypertension, or hypertension very refractory to treatment
2. onset of hypertension in those less than 30 years old (with no family history or obesity)
3. stable blood pressure values that acutely rise
4. onset of hypertension before puberty

What are some of the secondary causes of hypertension?
-Renal disease: virtually any cause
-Pheochromocytoma: remember to screen for MEN IIa and IIb
-Hyperaldosteronism: may have associated hypokalemia
-Cushing's syndrome: hypercortisolemia from any source
-Sleep apnea: zzzzzzz
-Medications: OCP, HRT, some NSAIDS, some antidepressants (eg Venlafaxine)
-Coarctation of the aorta

Canadian Hypertension Guidelines:"