PMID: 20626342Jul 16, 2010Paper

Secondary hypertension: the ways of management

Current Vascular Pharmacology
Gian P RossiAchille C Pessina

Abstract

The prevalence of secondary hypertension is lower than that of primary (essential) hypertension, but it is likely that it has been underestimated because appropriate tests were not generally performed. Hence, before embarking on a search for secondary hypertension physicians are generally advised to select populations of patients with a high pre-test probability of secondary forms of hypertension in order to maximize the positive predictive value and the gain in "ruling in" of the diagnostic tests. Based on updated information on prevalence and pathophysiology we herein critically review the general diagnostic strategy and the management of the main forms of secondary hypertension. In particular, strategies for identifying primary aldosteronism, the most frequent form of endocrine secondary hypertension, and for determining its unilateral or bilateral causes are discussed in details, because of the differences of treatment that requires adrenalectomy in the unilateral forms and mineralocorticoid receptor blockade in the bilateral forms. The tests available for the diagnosing pheochromocytoma (pheo), which is much rarer but extremely important to identify, as it can be fatal if unrecognized are also discussed, with emphasis on t...Continue Reading

Citations

Nov 23, 2011·Expert Review of Cardiovascular Therapy·Achille C Pessina, Gian Paolo Rossi
Dec 24, 2019·Frontiers in Endocrinology·Peter Igaz, Teresa Maria Seccia
Nov 8, 2020·High Blood Pressure & Cardiovascular Prevention : the Official Journal of the Italian Society of Hypertension·Gian Paolo RossiTeresa Maria Seccia

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