Secondary Hypertension: The Daily PANCE Blueprint

The answer is E. Hypoaldosteronism

Hypertension is a common problem affecting about 30% of the U.S. population. Most of the time, hypertension is benign/idiopathic, but about 5-10% of patients have secondary hypertension, which is hypertension with an actual underlying and (possibly) reversible cause. In adults, atherosclerosis, renal artery stenosis, and renal failure are the most common causes. You should suspect secondary hypertension in people with severe hypertension, hypertension refractory to medications, an age of onset younger than 30, or an acute rise in blood pressure. Other causes of secondary hypertension include obstructive sleep apnea, Cushing syndrome, hyperaldosteronism, medication/drug-induced (NSAIDS, amphetamines), and pheochromocytoma. Work-up for secondary hypertension may include urinalysis, renal ultrasound, transthoracic echocardiogram, TSH, renin and aldosterone levels, and sleep study.