Secondary arterial hypertension: when, who, and how to screen?

Rimoldi, Stefano; Scherrer, Urs; Messerli, Franz H (2014). Secondary arterial hypertension: when, who, and how to screen? European Heart Journal, 35(19), pp. 1245-1254. Oxford University Press 10.1093/eurheartj/eht534

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Secondary hypertension refers to arterial hypertension due to an identifiable cause and affects ∼5-10% of the general hypertensive population. Because secondary forms are rare and work up is time-consuming and expensive, only patients with clinical suspicion should be screened. In recent years, some new aspects gained importance regarding this screening. In particular, increasing evidence suggests that 24 h ambulatory blood pressure (BP) monitoring plays a central role in the work up of patients with suspected secondary hypertension. Moreover, obstructive sleep apnoea has been identified as one of the most frequent causes. Finally, the introduction of catheter-based renal denervation for the treatment of patients with resistant hypertension has dramatically increased the interest and the number of patients evaluated for renal artery stenosis. We review the clinical clues of the most common causes of secondary hypertension. Specific recommendations are given as to evaluation and treatment of various forms of secondary hypertension. Despite appropriate therapy or even removal of the secondary cause, BP rarely ever returns to normal with long-term follow-up. Such residue hypertension indicates either that some patients with secondary hypertension also have concomitant essential hypertension or that irreversible vascular remodelling has taken place. Thus, in patients with potentially reversible causes of hypertension, early detection and treatment are important to minimize/prevent irreversible changes in the vasculature and target organs.

Item Type:

Journal Article (Review Article)

Division/Institute:

04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology

UniBE Contributor:

Rimoldi, Stefano and Scherrer, Urs

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0195-668X

Publisher:

Oxford University Press

Language:

English

Submitter:

Stefano Rimoldi

Date Deposited:

11 May 2016 09:18

Last Modified:

23 Oct 2019 08:14

Publisher DOI:

10.1093/eurheartj/eht534

PubMed ID:

24366917

Uncontrolled Keywords:

Arterial hypertension; Obstructive sleep apnoea; Pheochromocytoma; Primary aldosteronism; Renal artery stenosis; Secondary hypertension

BORIS DOI:

10.7892/boris.43125

URI:

https://boris.unibe.ch/id/eprint/43125

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