Resistant hypertension, secondary hypertension, and hypertensive crises

Hall, W. Dallas

doi:10.1016/s0733-8651(01)00004-2

Cited by 23 publications

(11 citation statements)

References 45 publications

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“…We first ruled out renal diseases (glomerular and vascular) that are common aetiologies of secondary hypertension whether in black and non-black patients. [34] Renal impairment in our patient was related to malignant hypertension that is frequently associated with renal vascular damage due to markedly activated renin angiotensin system. [5] This was confirmed by the absence of glomerular injury signs (albuminuria, hematuria, hypoalbuminemia) on urinalysis and normal morphology of kidneys and vessels with CT-scan examination.…”

Section: Discussionmentioning

confidence: 99%

Pseudopheochromocytoma: An uncommon cause of malignant hypertension

Seck

Niang

et al. 2009

Indian J Nephrol

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A 42-year-old black African patient was admitted in the emergency department with severe headache, dizziness, and visual problems. He had been treated for hypertension diagnosed eight months ago after a similar episode. He was taking atenolol 100 mg /day, amlodipine 10 mg/day, and a combination of lisinopril 20 mg/hydrochlorothiazide 12.5 mg daily but experienced several hypertension peaks and hypotension. He adhered to treatment and was neither using traditional herbal medication nor illicit drugs. He did not smoke, but used to drink 1–2 glasses of wine after dinner. At admission, his blood pressure was 235/145 mm of Hg. His body mass index was 25.5 kg/m2 and the waist/hip ratio was 0.9. Physical examination was unremarkable. Fundoscopic examination revealed hypertensive retinopathy. Biochemical and imaging explorations were compatible with diagnosis of pseudopheochromocytoma. Evolution was favourable after treatment with alpha-1 and beta-blokers.

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Section: Discussionmentioning

confidence: 99%

Pseudopheochromocytoma: An uncommon cause of malignant hypertension

Seck

Niang

et al. 2009

Indian J Nephrol

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“…Sí existe numerosa bibliografía sobre etiología, fisiología, manejo y causas de las crisis hipertensivas [15][16][17][18][19][20] .…”

Section: Discussionunclassified

Crisis hipertensivas en pacientes como predictor de riesgo cardiovascular. Seguimiento durante 5 años

Hernández

Alemán

Jara

et al. 2009

Hipertensión y Riesgo Vascular

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“…Secondary causes of resistant hypertension include obstructive sleep apnea, chronic kidney disease, primary aldosteronism, renal artery stenosis, pheochromocytoma, Cushing’s disease, coarctation of the aorta, hyper- or hypothyroidism, and intracranial tumor1,3 and are present in approximately 10% to 20% of patients with resistant hypertension who are adherent with prescribed treatment 19…”

Section: Factors Associated With Resistant Hypertensionmentioning

confidence: 99%

“…Diuretic treatment is an important component of pharmacologic management of resistant hypertension since hypervolemia is common in patients with RH 19,24,45. Hypervolemia can result from excess sodium ingestion, progressive renal damage, fluid retention from blood pressure reduction, and underuse of diuretic treatment 18…”

Section: Obstructive Sleep Apneamentioning

confidence: 99%

“…Diuretics are underused in the treatment of hypetension1,37,46 for a variety of reasons, including concern regarding metabolic side effects and misconceptions about maximum dosages 3,36. Addition of, increasing the dose of, or changing the class of diuretic is a recommended first step in the treatment approach to RH24 and may improve blood pressure in up to 50% of patients 19,46…”

Section: Obstructive Sleep Apneamentioning

confidence: 99%

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Clinical approach in treatment of resistant hypertension

Frank¹,

Sommerfeld²

2009

IBPC

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Resistant hypertension, defined as failure to achieve target blood pressure despite the use of optimal or maximum doses of at least 3 agents, one of which is a diuretic, or requiring 4 or more medications to achieve blood pressure goal, is likely to affect up to 20% of all patients with hypertension. Apparent resistant hypertension may be caused by medication nonadherence, substances that either interfere with antihypertensive mediations or cause blood pressure elevation, and under- or inappropriate medication treatment. Certain patient characteristics are associated with the presence of resistant hypertension and include chronic kidney disease, diabetes, obesity, and presence of end-organ damage (microalbuminuria, retinopathy, left-ventricular hypertrophy). Secondary causes of resistant hypertension are not uncommon and include obstructive sleep apnea, chronic kidney disease, primary aldosteronism, renal artery stenosis, pheochromocytoma, and Cushing’s disease. Initial medication management usually includes adding or increasing the dose of a diuretic, which is effective in lowering the blood pressure of a large number of patients with resistant hypertension. Additional management options include maximizing lifestyle modification, combination therapy of antihypertensive agents depending on individual patient characteristics, adding less-commonly used fourth- or fifth-line antihypertensive agents, and referral to a hypertension specialist.

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Resistant hypertension, secondary hypertension, and hypertensive crises

Cited by 23 publications

References 45 publications

Pseudopheochromocytoma: An uncommon cause of malignant hypertension

Pseudopheochromocytoma: An uncommon cause of malignant hypertension

Crisis hipertensivas en pacientes como predictor de riesgo cardiovascular. Seguimiento durante 5 años

Clinical approach in treatment of resistant hypertension

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