Materiały źródłowe

• #1 Secondary Hypertension – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/sites/books/NBK544305/

  As stated above, up to 10% of adults with hypertension are found to have secondary hypertension. The prevalence of secondary hypertension varies with age and it is most prevalent at the extremes of age. It accounts for 70 to 85 percent of hypertension cases in children less than 12 years of age, and approximately 17 percent of cases in adults aged 65 and older. The prevalence of secondary hypertension is lowest amongst hypertensive patients who are 19 to 39 years of age while its prevalence in adolescents (12 to 18 years) is 10 to 15%. […] Renal parenchymal diseases are responsible for secondary hypertension in 3-5% of the people diagnosed with hypertension. The incidence of secondary hypertension increases with worsening renal functions and more than 2/3 of the patients with advanced chronic kidney disease are found to have hypertension. Primary aldosteronism is the main endocrine disorder leading to secondary hypertension and is found in as high as 5% of patients with hypertension. Renovascular hypertension accounts for 1% of the patients with hypertension and it has bimodal age distribution.

• #2 Secondary Hypertension: Discovering the Underlying Cause | AAFP

  https://www.aafp.org/pubs/afp/issues/2017/1001/p453.html

  Most patients with hypertension have no clear etiology and are classified as having primary hypertension. However, 5% to 10% of these patients may have secondary hypertension, which indicates an underlying and potentially reversible cause. The prevalence and potential etiologies of secondary hypertension vary by age. The most common causes in children are renal parenchymal disease and coarctation of the aorta. In adults 65 years and older, atherosclerotic renal artery stenosis, renal failure, and hypothyroidism are common causes. […] Secondary hypertension is a type of hypertension with an underlying and potentially reversible cause. It makes up only a small fraction (5% to 10%) of hypertensive cases. The prevalence of secondary hypertension varies by age and is more common in younger persons, with a prevalence close to 30% in those 18 to 40 years of age with hypertension.

• #2 Secondary Hypertension: Discovering the Underlying Cause | AAFP

  https://www.aafp.org/pubs/afp/issues/2017/1001/p453.html

  Secondary hypertension should be considered in the presence of suggestive signs and symptoms such as severe or resistant hypertension, onset before 30 years of age (especially before puberty), malignant or accelerated hypertension, and an acute rise in blood pressure from previously stable readings. […] Likely etiologies of secondary hypertension are different in children compared with adults. A summary of the most common causes of secondary hypertension by age is provided. Across all adult ages, renovascular hypertension, renal disease, aldosteronism, and obstructive sleep apnea (OSA) represent the most common causes of secondary hypertension. […] Renovascular hypertension is a common, potentially reversible cause of secondary hypertension. Although it may contribute to only 1% of mild hypertension cases, it accounts for 10% to 45% of severe or malignant hypertension cases in white patients.

• #3 Diagnosis of Secondary Hypertension: An Age-Based Approach | AAFP

  https://www.aafp.org/pubs/afp/issues/2010/1215/p1471.html

  Secondary hypertension is a type of hypertension with an underlying, potentially correctable cause. A secondary etiology may be suggested by symptoms (e.g., flushing and sweating suggestive of pheochromocytoma), examination findings (e.g., a renal bruit suggestive of renal artery stenosis), or laboratory abnormalities (e.g., hypokalemia suggestive of aldosteronism). Secondary hypertension also should be considered in patients with resistant hypertension, and early or late onset of hypertension. The prevalence of secondary hypertension and the most common etiologies vary by age group. Approximately 5 to 10 percent of adults with hypertension have a secondary cause. […] In the United States, one in three adults has hypertension. Most of these patients have no clear etiology and are classified as having essential hypertension. However, 5 to 10 percent have secondary hypertension, in which an underlying, potentially correctable etiology can be identified. Among children with hypertension, secondary causes are much more common. Whenever a patient is diagnosed with hypertension, one purpose of the initial assessment (i.e., history, physical examination, and basic laboratory testing) is to exclude possible secondary causes.

• #3 Diagnosis of Secondary Hypertension: An Age-Based Approach | AAFP

  https://www.aafp.org/pubs/afp/issues/2010/1215/p1471.html

  The most common etiologies in children, in whom 70 to 85 percent of cases of hypertension have a secondary cause, are different from those in older persons; therefore, an age-based approach to the differential diagnosis is recommended. […] The best initial test for aldosteronism is measurement of the aldosterone/renin ratio. It is the most sensitive test to detect primary aldosteronism, because approximately 25 percent of persons with the condition have normal aldosterone levels. […] Obstructive sleep apnea is a notable cause of secondary hypertension, particularly in 40- to 59-year-olds, but less so in those 60 years and older. […] Pheochromocytomas are rare tumors responsible for approximately 0.5 percent of cases of secondary hypertension. Patients typically present between 30 and 60 years of age. […] Renal artery stenosis secondary to atherosclerotic disease affects older adults. It should be suspected in those who develop hypertension after 50 years of age, have known atherosclerosis elsewhere, have unexplained renal insufficiency, or have a rapid deterioration in kidney function.

• #4 Secondary Hypertension: Causes & Symptoms

  https://my.clevelandclinic.org/health/diseases/21128-secondary-hypertension

  Secondary hypertension is high blood pressure that has a known cause. The cause might be another medical condition, or certain medicines or substances youre using. Often, treating this underlying cause can reduce your blood pressure to healthier levels. […] Most cases of hypertension are primary. Experts used to think that only 5% to 10% of high blood pressure cases have secondary causes. But recent research shows the actual number of secondary hypertension cases may be much higher. This is because many cases go unrecognized or are diagnosed as primary hypertension. […] Your healthcare provider may suspect secondary hypertension if: Your blood pressure is normally stable but suddenly goes up; You have high blood pressure before age 30; You develop dangerously high blood pressure (hypertensive crisis); Youre taking at least three medicines to lower your blood pressure, but its still high (resistant hypertension).

• #4 Secondary Hypertension: Causes & Symptoms

  https://my.clevelandclinic.org/health/diseases/21128-secondary-hypertension

  Untreated, secondary hypertension can lead to hypertensive heart disease. This is damage to your heart that results from years of high blood pressure. You may also develop complications from the condition thats raising your blood pressure. […] Secondary hypertension has a positive outlook with treatment. Early detection and treatment can lower the risk of damage to your blood vessels and heart from ongoing high blood pressure.

• #5 Endocrine Hypertension: The Urgent Need for Greater Global Awareness – touchENDOCRINOLOGY

  https://touchendocrinology.com/cardiovascular-risk/journal-articles/endocrine-hypertension-the-urgent-need-for-greater-global-awareness/

  Hypertension affects about 1.28 billion adults globally, and significantly increases the risk of chronic morbidity and mortality among sufferers. About 15% of these individuals have secondary hypertension, the majority of whom have dysfunction of one or more endocrine systems as the cause of hypertension. […] The prevalence of secondary hypertension is around 50% in hypertensive children, and 30% in young adults under the age of 40 years indicating that children and young adults should undergo secondary hypertension workup, even outside the resistant hypertension range. […] The prevalence of secondary hypertension is only 5-15% in the non-selected hypertensive population, whereas it can be around 30% in patients with resistant hypertension. […] Endocrine causes of secondary hypertension (endocrine hypertension) have been increasingly identified in recent years in parallel with improvement in our diagnostic armamentarium.

• #5 Endocrine Hypertension: The Urgent Need for Greater Global Awareness – touchENDOCRINOLOGY

  https://touchendocrinology.com/cardiovascular-risk/journal-articles/endocrine-hypertension-the-urgent-need-for-greater-global-awareness/

  The main causes of endocrine hypertension are summarized in Table 1. […] Investigating the cause of endocrine hypertension can be highly rewarding for both patients and physicians, as identifying a treatable endocrine disease can greatly improve the outcome, although this requires a high index of suspicion. However, the diagnosis is often delayed, or even never made due to inadequate awareness among physicians. […] Although endocrine hypertension is common with a prevalence of about 10% among hypertensive individuals and about 20% of those with resistant hypertension, the diagnosis is often missed because of poor awareness among healthcare workers and the subtle symptoms in individuals with the disease.

• #6 Improved identification of secondary hypertension: use of a systematic protocol

  https://atm.amegroups.org/article/view/20388/html

  These results illustrate the prevalence and distribution of the causes of secondary hypertension using a systematic, protocolled approach, which revealed a higher percentage of secondary hypertension than previously reported. […] Secondary hypertension (SH) is best defined as a form of hypertension with an identifiable cause and is generally considered to affect approximately 510% of all hypertensive patients. […] Nevertheless, in a comprehensive review of published work, there were significant variations of the estimated prevalence of SH, ranging from 2% to 20% depending on the underlying etiology leading to high blood pressure (HBP) and the availability of adequate diagnostic laboratory and imaging resources. […] While many diagnostic tools exist to assess SH, physicians and other healthcare providers who treat hypertension may find it difficult to detect due to the multiple etiologies and suboptimal recognition of the condition.

• #6 Improved identification of secondary hypertension: use of a systematic protocol

  https://atm.amegroups.org/article/view/20388/html

  The accurate identification and diagnosis of secondary hypertension is critical, especially while atherosclerotic cardiovascular heart disease continues to be the leading cause of death in the industrialized world. […] Nevertheless, despite the existence of diagnostic tools, there are significant variations of the estimated prevalence of secondary hypertension, due to multiple etiologies and suboptimal recognition. […] This study demonstrates the results of using a systematic and protocolled approach to improve recognition of the presence of secondary hypertension. […] A total of 28,633 consecutive patients from January 1, 2007 to January 1, 2017 were diagnosed as having primary or secondary hypertension, utilizing the International Code of Diseases. […] A final population of 12,284 patients with treatment resistant hypertension (TRH) and non-treatment resistant hypertension (NTRH) were included in this study, where an etiology of secondary hypertension was identified in 50.9% and 36% of patients in each treatment group, respectively.

• #6 Improved identification of secondary hypertension: use of a systematic protocol

  https://atm.amegroups.org/article/view/20388/html

  Utilizing the methods developed in the Center, this approach, known as the CHIC Protocol, could constitute a valuable tool for early recognition and accurate diagnosis of SH in clinical practice. […] Although secondary causes of hypertension are common in patients with resistant hypertension, a higher prevalence of SH persisted independent of the measured severity of BP values and SH was also identified in patients with moderate hypertension. […] Our results illustrate the prevalence and distribution of the causes of SH using the CHIC Protocol, revealing a higher percentage of SH than previously reported. […] If the generalized concept that associates SH mainly with severe, resistant hypertension remains unchanged, many patients as described in our population would never be diagnosed.

• #7 Chapter 13. Secondary hypertension | Hypertension Research

  https://www.nature.com/articles/hr201416

  Hypertension related to a specific etiology is termed secondary hypertension, markedly differing from essential hypertension, of which the etiology cannot be identified, in the condition and therapeutic strategies. […] Secondary hypertension is often resistant hypertension, for which a target blood pressure is difficult to achieve by standard treatment. However, blood pressure can be effectively reduced by identifying its etiology and treating the condition. Therefore, it is important to suspect secondary hypertension and reach an appropriate diagnosis. […] It has been recognized that secondary hypertension accounts for 10% of hypertensive patients, but a study indicated that the incidence of PA was higher than previously reported; at least 10% of hypertensive patients may have secondary hypertension.

• #7 Chapter 13. Secondary hypertension | Hypertension Research

  https://www.nature.com/articles/hr201416

  Generally, the presence of severe or resistant hypertension, juvenile hypertension and the rapid onset of hypertension suggest the possibility of secondary hypertension. […] The possibility of secondary hypertension should be considered in the diagnosis and treatment of all hypertensive patients. […] Renovascular hypertension (RVHT) is hypertension caused by stenosis or obstruction of the renal artery and is observed in about 1% of all hypertensive patients. […] Renovascular hypertension is caused by stenosis or obstruction of the renal artery and is observed in about 1% of hypertensive patients. […] A study reported that sleep apnea syndrome was the most frequent factor for secondary hypertension. […] The number of patients with secondary hypertension may further increase with the widespread diagnosis of sleep apnea syndrome.

• #8

  https://healthmatch.io/high-blood-pressure/what-is-secondary-hypertension

  Secondary hypertension is not as prevalent as primary hypertension, accounting for 5-10%. […] The prevalence and causes of secondary hypertension vary by age. It accounts for many hypertensive cases among children and young people. […] The causes of secondary hypertension vary depending on age. Since secondary hypertension only happens when there is an underlying condition, it has many causes. […] The causes of secondary hypertension vary by age, whereas essential hypertension increases by age. Secondary hypertension is far more prevalent in children under 11. They account for 70-85% of all diagnosed secondary hypertension cases. […] Early diagnosis of secondary hypertension and appropriate targeted treatment can potentially improve blood pressure. […] The key to treating secondary hypertension is treating the underlying medical condition. Once you receive treatment for the underlying condition, you may be able to manage your hypertension easily. […] Secondary hypertension is less common, and its rarity makes it difficult to diagnose the condition without in-depth investigations.

• #9 Secondary Hypertension in Young Adultslogo-32logo-40logo-60NEJM Journal WatchnejmJW_1L_RGB-b

  https://www.jwatch.org/na58060/2024/11/07/secondary-hypertension-young-adults

  Patients in their 30s had higher rates of secondary hypertension than did younger adults, which highlights potential gaps in screening recommendations. […] The prevalence of secondary causes of hypertension varies depending on the studied population. Data suggest that 10% of adults with hypertension have secondary causes, although this percentage likely is an underestimate. Current American College of Cardiology/American Heart Association guidelines recommend screening for secondary causes of hypertension in patients who are younger than 30. […] Key findings were as follows: Secondary hypertension was noted in 30% of patients overall. Notably, patients who were 30 to 40 years old were more likely to have secondary causes than were those who were 18 to 30 years old. […] Secondary causes for hypertension, particularly primary aldosteronism, remain underdiagnosed. In part, this is because current screening strategies that employ aldosterone-to-renin ratios can be challenging to interpret and have variable sensitivity. Nonetheless, early detection is critical, as many secondary causes have targeted treatments which are different from standard first-line therapies. We should broaden our thinking about which patients should be screened to ensure that secondary hypertension is identified and treated promptly in patients at risk.

• #10 Hypertension

  https://mobile.fpnotebook.com/CV/Htn/Hyprtnsn.htm

  Secondary Hypertension accounts for 5-10% of Hypertension Causes overall. […] In age 18 to 40 years old, accounts for 30% of Hypertension.

• #11

  https://journals.lww.com/jhypertension/abstract/2015/06001/lb01_11__prevalence_of_secondary_hypertension_in.123.aspx

  Data from referral centers suggest that approximately 10% of hypertensive patients could have secondary hypertension (2HTN). It is commonly accepted that 2HTN is more frequent in younger subjects but its prevalence is not known. […] Between January 2008 and December 2013, 843 patients (52.2% women) aged 26.9 6.2 years were referred to our center. […] 250 patients (29.6%) were diagnosed with 2HTN including primary aldosteronism in 62 patients (7.4 %), fibromuscular dysplasia in 49(5.8%) and pheochromocytoma in 33 (3.9%) patients. […] Before the age of 40, the prevalence of 2HTN is close to 30%. This high prevalence confirms the necessity of a systematic work-up for 2HTN in younger adults.

• #12 Secondary Hypertension in Young Adults With Hypertension Common Despite Age, BP – The Cardiology Advisor

  https://www.thecardiologyadvisor.com/news/secondary-hypertension-in-young-adults-with-hypertension-common-despite-age-bp/

  Among young adults with hypertension, secondary hypertension is common regardless of BP level and age. […] The investigators found 29.6% of patients had secondary HTN, which was most frequently associated with primary aldosteronism (54.8%), renovascular hypertension (18.4%), primary kidney disease (12.9%), pheochromocytoma/functional paraganglioma (6.0%), and hypertension caused by drugs or substances (5.2%). […] According to our study, 2HTN [secondary hypertension] is frequent and significantly more common in patients with hypertension aged 18 to 40 years than the prevalence reported in the general hypertensive population, the investigators concluded. We failed to identify a population with a low risk of 2HTN, and studies analyzing precisely the determinants of each cause of 2HTN are needed to narrow the population of patients at risk for 2HTN.

• #13

  https://journals.lww.com/jhypertension/abstract/2021/04001/prevalence_of_secondary_hypertension_in_patients.1078.aspx

  Resistant hypertension is defined as blood pressure that remains above therapeutic goal despite concurrent use of three antihypertensive agents (at full or maximum tolerated doses) of different classes, one of which is a diuretic. The prevalence of secondary hypertension among patients with resistant hypertension is not exactly known. […] Among the 432 patients with resistant hypertension, secondary etiology of hypertension was found in 135 (31.1%). […] Secondary etiology was much more frequent (31%) in our group of patients with resistant hypertension than in non-selected hypertensive population (515%). Patients with secondary hypertension had more advanced target organ damage.

• #14 Resistant Hypertension: An Overview | ECR Journal

  https://www.ecrjournal.com/articles/global-burden-resistant-hypertension-and-potential-treatment-options?language_content_entity=en

  Resistant hypertension (RH) is defined as systolic blood pressure (SBP) or diastolic blood pressure (DBP) that remains 140 mmHg or 90 mmHg, respectively, despite an appropriate lifestyle and the use of optimal or maximally tolerated doses of a three-drug combination, including a diuretic. […] RH affects about 5% of the hypertensive population and is associated with increased cardiovascular morbidity and mortality. […] The global burden of RH is relevant, with approximately 100500 million people globally estimated to be affected. […] In a meta-analysis including data from 91 cohort or cross-sectional studies comprising more than 3.2 million patients, the prevalence of RH was about 10% among patients treated for hypertension. […] After strictly applying the above definition of RH, a reasonable estimate of disease prevalence could be around 5% of the overall population with hypertension.

• #14 Resistant Hypertension: An Overview | ECR Journal

  https://www.ecrjournal.com/articles/global-burden-resistant-hypertension-and-potential-treatment-options?language_content_entity=en

  RH prevalence is higher among patients with diabetes and hypertension-mediated organ damage (HMOD), including albuminuria, left ventricular hypertrophy and chronic kidney disease (CKD). […] Secondary causes of hypertension must be checked, according to the patients medical history and physical examination. […] Secondary causes account for 510% of hypertension cases, particularly primary aldosteronism and atherosclerotic renal artery stenosis.

• #15 Ruling out secondary causes of hypertension | EuroIntervention

  https://eurointervention.pcronline.com/article/ruling-out-secondary-causes-of-hypertension

  In contrast, in the minority of patients with secondary hypertension a specific underlying cause is responsible for the elevated blood pressure. The prevalence of secondary hypertension is higher in patients with resistant hypertension than in the general hypertensive population and increases with age. […] Consequently, screening for secondary causes of hypertension plays an essential part in the care of patients with arterial hypertension. […] The prevalence of primary aldosteronism (PA) is greater than previously thought. […] Among untreated patients, the prevalence of PA increases in parallel with the increasing severity of the hypertension, from 2% in patients with stage 1 hypertension to 8% in those with stage 2 hypertension and 13% in those with stage 3 hypertension. […] Even in the general population, and particularly in men, obstructive sleep apnoea (OSA) is a common finding.

• #15 Ruling out secondary causes of hypertension | EuroIntervention

  https://eurointervention.pcronline.com/article/ruling-out-secondary-causes-of-hypertension

  Approximately 30% of adults with hypertension have OSA. […] Drug-induced hypertension is one of the most common causes of secondary hypertension and is often found in clinical practice. […] There are a number of rare causes of secondary hypertension, which cannot be discussed in detail in this article.

• #16 Eye-Opening Study Looks at Prevalence of Secondary Hypertension

  https://www.straighthealthcare.com/secondary-hypertension-prevalence.html

  Cross-sectional study finds secondary hypertension is prevalent in 30% of hypertensive adults aged 18 to 40 […] Studies have suggested that secondary hypertension may be present in 10% of individuals with hypertension and up to 30% of those with resistant hypertension. […] Secondary hypertension was identified in 29.6% of participants (N=619), with the most frequent etiologies being: Primary aldosteronism (54.8%), Primary kidney disease (12.9%), Drugs or substances (6%), Pheochromocytoma/functional paraganglioma (5.9%), Other (2.7%). […] Factors associated with a higher prevalence of secondary causes included female sex, hypokalemia, treatment with at least two medications, no family history of hypertension, BMI less than 25, and diabetes.

• #17

  https://link.springer.com/article/10.1007/s12170-014-0388-3

  Secondary hypertension is more common in children compared with adults who predominantly have primary hypertension. […] Young age, severe hypertension, family history, and signs and symptoms of syndromes associated with hypertension are suggestive of an underlying secondary cause for elevated BP. […] Secondary hypertension is associated with more severe elevation in BP and, hence, early and prompt diagnosis with treatment addressing the underlying cause is needed for such patients. […] Renal conditions are the commonest cause of secondary hypertension in children and include chronic kidney injury, acute nephritic syndromes, renal artery stenosis, and renal scarring. […] Hypertension is also seen in association with Williams syndrome, neurofibromatosis, and others in association with renal vessel abnormalities.

• #17

  https://link.springer.com/article/10.1007/s12170-014-0388-3

  Iatrogenic steroid use for various conditions is one of the most common causes for hypertension in children. […] Other endocrine conditions associated with hypertension include catecholamine producing tumors (pheochromocytoma), corticoid hormone disorders (Cushings syndrome and disease, hyperaldosteronisn, congenital adrenal hyperplasia), and hyperthyroidism. […] Genetic forms of hypertension are rare but should be suspected in patients with early onset of elevated BP, young family members with hypertension and associated electrolyte abnormalities of alkalosis and hypokalemia.

• #18 Secondary hypertension – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/secondary-hypertension/symptoms-causes/syc-20350679

  Secondary high blood pressure (secondary hypertension) is high blood pressure that’s caused by another medical condition. […] Secondary hypertension differs from the usual type of high blood pressure (primary hypertension or essential hypertension), which is often called simply high blood pressure. […] Proper treatment of secondary hypertension can often control both the high blood pressure and the condition that causes it. Effective treatment reduces the risk of serious complications including heart disease, kidney failure and stroke. […] The greatest risk factor for developing secondary hypertension is having a medical condition that can cause high blood pressure, such as kidney, artery, heart or endocrine system problems. […] Secondary hypertension can worsen the underlying medical condition that’s causing the high blood pressure. Without treatment, secondary hypertension can lead to other health problems, such as: […] If you have high blood pressure, you’re more likely to have other components of metabolic syndrome. The more components you have, the greater your risk of developing diabetes, heart disease or stroke.

• #19 Factors predicting secondary hypertension in young adults with hypertension: a retrospective study | BMC Cardiovascular Disorders | Full Text

  https://bmccardiovascdisord.biomedcentral.com/articles/10.1186/s12872-025-04520-2

  Hypertension in young adults is often due to secondary causes, and investigating these can be resource-intensive. This study aimed to identify clinical and biochemical markers that could suggest secondary hypertension in individuals under 40 years. […] Secondary hypertension was diagnosed in 7 patients (3.4%). The most common diagnoses were primary aldosteronism and hyperthyroidism. […] Approximately 58% of young adult patients are found to have secondary causes of hypertension. […] Several easy-to-obtain clinical and biochemical markers can help identify secondary hypertension in young adults. […] The present study reported a prevalence of secondary causes of hypertension (3.4%), compared to other studies which reported a prevalence ranging from 2 to 8%. […] The key finding in this study was the identification of three easily obtainable clinical and biochemical factors that could predict secondary causes of hypertension in young hypertensive adults. […] Utilizing these predictors may reduce the need for specific referrals and avoid unwarranted investigations.

• #20 Secondary hypertension in adults | SMJ

  http://www.smj.org.sg/article/secondary-hypertension-adults

  Secondary hypertension occurs in a significant proportion of adult patients (~10%). […] About 10% of patients with hypertension have a secondary cause. […] Failure to recognise secondary causes can lead to resistant hypertension, cardiovascular complications or complications of the underlying condition. […] In older adults, primary aldosteronism, RAS and OSA are common and often underdiagnosed. Screening tests, if available, should be performed to detect these conditions. […] Diagnosis and treatment of causes of secondary hypertension can lead to good clinical outcomes.

• #21 Secondary Hypertension Causes, Symptoms, and Treatments

  https://www.upmc.com/services/kidney-disease/conditions/hypertension

  Your secondary hypertension prognosis depends on the cause and severity of your condition, as well as your overall health. […] By identifying the cause of your hypertension, your nephrologist can work with you to develop a personalized plan to treat your condition and get your blood pressure under control. […] Renal denervation is a highly successful procedure for secondary hypertension. Most people see a drop in their blood pressure numbers and can reduce their blood pressure medications. Some people may be able to stop taking blood pressure medications completely.

• #22 Hypertension: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/241381-overview

  Hypertension is a worldwide epidemic; accordingly, its epidemiology has been well studied. Data from the US National Health and Nutrition Examination Survey (NHANES) spanning 2011-2014 found that of those in the population aged 20 years or older, an estimated 86 million adults had hypertension, with a prevalence of 34%. […] More recently, 2020 data from the Centers for Disease Control and Prevention’s (CDC) National Center for Health Statistics (NCHS) spanning 2017-2018 show a 45.4% prevalence of hypertension among those aged 18 and older. […] Globally, an estimated 26% of the worlds population (972 million people) has hypertension, and the prevalence is expected to increase to 29% by 2025, driven largely by increases in economically developing nations. […] The high prevalence of hypertension exacts a tremendous public health burden. For example, as a primary contributor to heart disease and stroke, the first and third leading causes of death worldwide, respectively, high BP was the top modifiable risk factor for disability adjusted life-years lost worldwide in 2013. […] Black adults have among the highest rates of hypertension, with an increasing prevalence, in the United States and globally. […] Although White adults also have an increasing incidence of high BP, they develop this condition later in life than Black adults and have much lower average BPs.

• #23 The global epidemiology of hypertension | Nature Reviews Nephrology

  https://www.nature.com/articles/s41581-019-0244-2

  Hypertension is the leading cause of cardiovascular disease and premature death worldwide. […] The prevalence of hypertension has increased, especially in low- and middle-income countries (LMICs). […] Estimates suggest that 31.1% of adults (1.39 billion) worldwide had hypertension in 2010. […] The prevalence of hypertension among adults was higher in LMICs (31.5%, 1.04 billion people) than in high-income countries (28.5%, 349 million people). […] Despite the increasing prevalence, the proportions of hypertension awareness, treatment and BP control are low, particularly in LMICs, and few comprehensive assessments of the economic impact of hypertension exist. […] Future studies are warranted to test implementation strategies for hypertension prevention and control, especially in low-income populations, and to accurately assess the prevalence and financial burden of hypertension worldwide.

• #24

  https://www.who.int/news-room/fact-sheets/detail/hypertension

  The prevalence of hypertension varies across regions and country income groups. The WHO African Region has the highest prevalence of hypertension (27%) while the WHO Region of the Americas has the lowest prevalence of hypertension (18%). […] The number of adults with hypertension increased from 594 million in 1975 to 1.13 billion in 2015, with the increase seen largely in low- and middle-income countries. This increase is due mainly to a rise in hypertension risk factors in those populations. […] The World Health Organization (WHO) supports countries to reduce hypertension as a public health problem. […] In 2021, WHO released a new guideline for on the pharmacological treatment of hypertension in adults. The publication provides evidence-based recommendations for the initiation of treatment of hypertension, and recommended intervals for follow-up.

• #24

  https://www.who.int/news-room/fact-sheets/detail/hypertension

  To support governments in strengthening the prevention and control of cardiovascular disease, WHO and the United States Centers for Disease Control and Prevention (U.S. CDC) launched the Global Hearts Initiative in September 2016, which includes the HEARTS technical package. […] Since implementation of the programme in 2017 in 31 countries low- and middle-income countries, 7.5 million people have been put on protocol-based hypertension treatment through person-centred models of care. These programmes demonstrate the feasibility and effectiveness of standardized hypertension control programmes.

• #25 Hypertension – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/hypertension/

  Hypertension affects between approximately one-third and one-half of adults in the US. […] Secondary hypertension: accounts for 10% of cases of hypertension in adults. […] Prevalence increases with age: Approximately 65-75% of adults develop hypertension by 65-74 years of age. […] Rates are highest in African American individuals, followed by white individuals, and lowest in Asian American and Hispanic individuals. […] 60-87% of overweight and 73-95% of obese patients are affected. […] Secondary hypertension usually manifests with symptoms of the underlying disease. […] Most common causes in adults include: thyroid dysfunction, fibromuscular dysplasia, and renal parenchymal disease. […] Most common causes in children and adolescents (parenchymal disease and coarctation of the aorta).

• #26 The Modern Environment: The New Secondary Cause of Hypertension?

  https://www.mdpi.com/1648-9144/59/12/2095

  The most important risk factor for cardiovascular disease, the leading cause of death worldwide, is hypertension. […] Although most cases of hypertension are thought to be essential, the multifactorial associations of the environmental influence on blood pressure seem to play an important role and should be more closely investigated. […] According to the World Health Organization, 1.13 billion people worldwide have hypertension, and the numbers are expected to become higher in the following years. […] In the United States, nearly half of adults (47%) have hypertension, defined either as abnormal values of blood pressure (BP) or as the use of antihypertension treatment. […] According to the May Measurement Month 2017, which is an annual initiative launched by the International Society of Hypertension as a way to tackle the widespread lack of awareness regarding hypertension, more than 1.2 million individuals from 80 different countries were enrolled and subjected to analysis, with nearly one-third of them being identified as hypertensive.

• #26 The Modern Environment: The New Secondary Cause of Hypertension?

  https://www.mdpi.com/1648-9144/59/12/2095

  An acknowledgement of novel elements—further than the well-known, previously reported ones—that influence the development and management of hypertension seems, nowadays, to be more than crucial. […] Evidence suggests that environmental factors play a key role not only in the onset of hypertension but also in the success of the treatment. […] Hence, this review aims to study the environmental impact on hypertension by searching the recently published literature regarding seasonal variation, noise pollution, and obesity. […] There is a strong relationship between noise pollution and cardiovascular events. […] The effect of noise on hypertension has been examined and proved to be both short- and long-term. […] Beyond noise pollution, air pollution seems also to be an important environmental factor of hypertension.

• #26 The Modern Environment: The New Secondary Cause of Hypertension?

  https://www.mdpi.com/1648-9144/59/12/2095

  The importance of socioeconomic status, lifestyle preferences, and dietary practices should be researched extensively due to the close relationships between these factors and the onset, but also regulation, of hypertension. […] Most cases of hypertension are classified as essential. Environmental factors like socioeconomic conditions, climate change, and lifestyle choices influence hypertension. […] A revision in the categorization of hypertension could be important, as even in the case of essential, primary hypertension, the environment could be found to constitute it as secondary.

• #27 Secondary hypertension – Wikipedia

  https://en.wikipedia.org/wiki/Secondary_hypertension

  Neuroendocrine tumors are also a well known cause of secondary hypertension. […] Because of the ubiquity of arsenic in ground water supplies and its effect on cardiovascular health, low dose arsenic poisoning should be inferred as a part of the pathogenesis of idiopathic hypertension. […] Establishing potassium balance has been shown to reverse hypertension.

• #28 Hypertension – Cardiovascular Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/cardiovascular-disorders/hypertension/hypertension

  Hypertension with an identified cause (secondary hypertension) is usually due to primary aldosteronism. Sleep apnea, chronic kidney disease, or renal artery stenosis are other causes of secondary hypertension. […] Common causes include (1) Obstructive sleep apnea, Renal parenchymal disease: Chronic glomerulonephritis or pyelonephritis, polycystic renal disease, lupus nephritis, obstructive uropathy, Renovascular disease, Primary aldosteronism (2), Other endocrine disorders (less common): Pheochromocytoma, Cushing syndrome, congenital adrenal hyperplasia, hyperthyroidism, hypothyroidism (myxedema), primary hyperparathyroidism, acromegaly, and mineralocorticoid excess syndromes other than primary aldosteronism, Prescription or over-the-counter medications: Sympathomimetics (decongestants), nonsteroidal anti-inflammatory drugs (NSAIDs), antipsychotics, tyrosine kinase inhibitors, angiogenesis inhibitors, stimulants, corticosteroids, cocaine, Vascular anomalies: Coarctation of the aorta. […] The prevalence of primary aldosteronism is higher than previously recognized, occurring in approximately 10 to 20% of patients with resistant hypertension.

• #29 Prevalence and risk factors for secondary hypertension among young Korean men

  https://www.imrpress.com/journal/RCM/21/4/10.31083/j.rcm.2020.04.121/htm

  Multiple logistic regression analysis revealed five major predictive factors for secondary HTN. Abnormal TFT results had the strongest association with secondary HTN. […] Secondary HTN is rare in relatively healthy hypertensive patients aged < 30 years. Therefore, in this population, screening for secondary HTN should be considered in the presence of any predictive factors, such as abnormal TFT findings, proteinuria, hematuria, severe HTN, or non-overweight, to ensure cost-effectiveness.

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