Approach to a young patient with hypertension General Evaluation - History and Examination, Basic chemistries (K, eGFR), Urinalysis Renal Imaging (parenchyma + vasculature) Plasma aldosterone and renin activity (evaluate based on profile) ↑AIdo/↑PRA: Secondary HA (malignant HTN, RAS, CoAo, large vessel vasculopathies, reninoma) ↑AIdo/↓PRA: Primary HA (adenoma, hyperplasia, GRA, carcinoma) ↓AIdo/↓PRA: Cushing, CAH, AMES, Liddle, low-renin essential HTN If work-up unrevealing: Consider sleep apnea, thyroid disease, hyperparathyroidism, pheochromocytoma, primary CNS disease #hypertension #young #early #secondary #workup #algorithm
