Screening for endocrine hypertension. An Endocrine Society scientific statement

Authors

  • William F. Young Jr. Mayo Clinic, Rochester, Minnesota, United States
  • David A. Calhoun University of Alabama at Birmingham, Birmingham, Alabama, United States
  • Jacques W.M. Lenders Radboud University Medical Centre, Nijmegen, Netherlands; University Hospital Carl Gustav Carus, Technische Universitat Dresden, Germany, Germany

Keywords:

arterial hypertension, endocrine hypertension, Endocrine Society

Abstract

Hypertension may be the initial clinical presentation for at least 15 endocrine disorders. An accurate diagnosis of endocrine hypertension provides clinicians with the opportunity to render a surgical cure or to achieve an optimal clinical response with specific pharmacologic therapy. It is challenging for the clinician to know when and how to perform case-detection testing for all the endocrine disorders in which hypertension may be the presenting symptom. Herein, we review the different forms of endocrine hypertension, with a focus on prevalence, clinical presentation, guidance on when to perform case detection testing, and currently available case-detection tests.

Hypertension affects 28.6% of adults in United States. In most, hypertension is primary (essential or idiopathic), but a subgroup of approximately 15% has secondary hypertension. More than 50% of children who present with hypertension have a secondary cause. In young adults (< 40 years old), the prevalence of secondary hypertension is approximately 30%. The secondary causes of hypertension include renal causes (e.g., renal parenchymal disease) and endocrine causes. Hypertension may be the initial clinical presentation many endocrine disorders: pheochromocytoma and sympathetic paraganglioma, primary aldosteronism, hyperdeoxycorticosteronism (congenital adrenal hyperplasia – 11b-hydroxylase deficiency, 17a-hydroxylase deficiency, deoxycorticosterone-producing tumor, primary cortisol resistance), cushing syndrome, apparent mineralocorticoid excess / 11b-hydroxysteroid dehydrogenase deficiency, hyperparathyroidism, secondary hyperaldosteronism, renovascular hypertension, hypothyroidism, hyperthyroidism, obstructive sleep apnea and others.

Clinical context is important. For example, case detection for endocrine hypertension may not be clinically important in an older patient with multiple life-limiting comorbidities. However, screening for endocrine hypertension may be key to enhancing and prolonging life in most patients with hypertension, especially younger patients.

Author Biographies

William F. Young Jr., Mayo Clinic, Rochester, Minnesota

Division of Endocrinology, Diabetes, Metabolism, Nutrition, and Internal Medicine

David A. Calhoun, University of Alabama at Birmingham, Birmingham, Alabama

Calhoun, Vascular Biology and Hypertension Program, Division of Cardiovascular Disease, Department of Medicine

Jacques W.M. Lenders, Radboud University Medical Centre, Nijmegen, Netherlands; University Hospital Carl Gustav Carus, Technische Universitat Dresden, Germany

Lenders, Department of Internal Medicine

Department of Internal Medicine III

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Published

2017-12-28

How to Cite

Young Jr., W. F., Calhoun, D. A., & Lenders, J. W. (2017). Screening for endocrine hypertension. An Endocrine Society scientific statement. REPRODUCTIVE ENDOCRINOLOGY, (38), 58–71. Retrieved from https://reproduct-endo.com/article/view/119840

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Section

Interdisciplinary problems