Morning Report

When High Blood Pressure Is the Tip of the Iceberg: Uncovering Endocrine Hypertension

Arefa Cassoobhoy, MD, MPH

April 21, 2017

Hello. I'm Dr Arefa Cassoobhoy, a practicing internist and a medical editor for Medscape and WebMD. Welcome to Morning Report, our 1-minute news story for primary care.

When to Think About Secondary Hypertension

Your patient's hypertension may be the result of an endocrine disorder. About 15% of people who present with high blood pressure have secondary hypertension, and that number rises in younger adults and children.

Now, the Endocrine Society has released guidelines on when to suspect a hormone disorder and how to test for it.

There is specific information on primary aldosteronism. Once thought to be rare, primary aldosteronism accounts for at least 5%-10% of hypertensive patients, and many have normal potassium levels—not hypokalemia.

Primary aldosteronism is treatable and potentially curable. Early treatment also decreases the risk for cardiovascular events and kidney disease. The aldosterone/renin ratio (ARR) is the most reliable available screening test.

The Endocrine Society emphasizes that 15 hormonal disorders can present with hypertension, so the bottom line is that we need to consider a workup for secondary hypertension more often. Many of our patients would benefit from screening for primary aldosteronism.

For Medscape and WebMD, I'm Dr Arefa Cassoobhoy.

Follow Dr Cassoobhoy on Twitter: @ArefaMD

Any views expressed above are the author's own and do not necessarily reflect the views of WebMD or Medscape.

Cite this: When High Blood Pressure Is the Tip of the Iceberg: Uncovering Endocrine Hypertension - Medscape - Apr 21, 2017.

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