Causes of Secondary Hypertension - Workup and Differential Diagnosis Approach (when evaluation should be done): 1. Severe or resistant hypertension: Resistant hypertension is defined as the persistence of hypertension despite concurrent use of adequate doses of three antihypertensive agents from different classes, including a diuretic. 2. An acute rise or increased lability in blood pressure developing in a patient with previously stable values. 3. Age less than 30-40 years in non-obese, non-black patients with a negative family history of hypertension and no other risk factors (eg, obesity) for hypertension. 4. Onset of diastolic hypertension at an older age (> 55 years) 5. Malignant or accelerated hypertension (eg, patientswith severe hypertension and signs of end-organ damage such as retinal hemorrhages or papilledema, heart failure, neurologic disturbance, or acute kidney injury). 6. Hypertension associated with electrolyte disorders including hypokalemia and metabolic alkalosis. 7. Proven age of onset before puberty. 8. Stage 2 hypertension (blood pressure >160-179/100-109 mm Hg) with clinical suspicion of either renovascular or endocrine causes of hypertension (eg, presence of renal bruit or signs of hormonal excess or hypokalaemia). 9. Stage 3 hypertension (blood pressure >180/110 mm Hg). Causes: • Vascular: Renal artery stenosis, Coarctation of aorta, Vasculitis • Endocrinologic: Hypothyroidism, Primary Hyperaldosteronism, Hyperthyroidism, Hypercalcemia, Cushing's syndrome, Acromegaly, Pheochromocytoma • Toxic: NSAlDs, Glucocorticoid, Estrogens, Sympathomimetic, Alcohol, Cocaine, Amphetamines • Other: 1. Renal parenchymal disease: CKD, acute glomerulonephritis, andscleroderma renalcrisis 2. Obstructive sleep apnea: CPAP, most pts have HTN 3. White-coat syndrome: 24-hour ABPM 4. Pregnancy-associated 5. Neurologic disorders: Increased intracranial pressure (Cushing'sresponse), quadriplegia, dysautonomia, and Guillain-Barre Syndrome - Dr. Jorge Cortés @Jcortesizaguirr #Secondary #Hypertension #Workup #causes #Differential #Diagnosis #indications
