Secondary Causes of Hypertension in Patients With Resistant Arterial Hypertension

Abstract

Objective: Resistant hypertension is defined as blood pressure that remains above therapeutic goal despite concurrent use of three antihypertensive agents (at full or maximum tolerated doses) of different classes, one of which is a diuretic. The prevalence of secondary causes of hypertension among patients with resistant hypertension is not exactly known. Design and method: We retrospectively analysed the hospital records of patients with resistant arterial hypertension, who underwent complete laboratory and imaging examinations to exclude the secondary etiology of arterial hypertension. Standard descriptive statistics were used for statistical evaluation. Results: Among the 600 patients with resistant hypertension, secondary etiology of hypertension was found in 160 (27,5%). The most frequent cause was primary aldosteronism in 93 cases (58% relatively), followed by renovascular hypertension (30 cases, 18.8%), renal parenchymal hypertension (25 cases, 15,6%). Less common causes were pheochromocytoma (3,1%), hyperreninism (3.1%), hypercortisolism (0,6%). Obstructive sleep apnoea has been found in 75 (12.5%) patients. Conclusion: Secondary etiology was much more frequent (27,5%) in our group of patients with resistant hypertension than in non-selected hypertensive population (5–15%). Conclusions: This work was supported by IGA_LF_2019_036, IGA_LF_2020_039

Endocrine Hypertension: The Urgent Need for Greater Global Awareness

“…6 The prevalence of secondary hypertension is only 5-15% in the non-selected hypertensive population, whereas it can be around 30% in patients with resistant hypertension. 7 Hence, working up patients with resistant hypertension is crucial to identifying a potential secondary cause. 8 Endocrine causes of secondary hypertension (endocrine hypertension) have been increasingly identified in recent years in parallel with improvement in our diagnostic armamentarium.…”