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Flashcards in Secondary Hypertension Deck (27)
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1

What is essential hypertension?

No clear etiology causing hypertension

2

What is secondary hypertension?

Underlying (potentially correctable) etiology

3

What are the statistics for occurrence of secondary hypertension?

1/3 of adults have hypertension and 5-10% of those adults have secondary HTN; children with hypertension almost all have secondary hypertension

4

What is one strong indication for the presence of secondary hypertension?

Resistant hypertension: elevated BP despite patients adherence to optimal dosage of 3 antihypertensive agents including a diuretic

5

What is arm to leg systolic BP difference over 20 mmHg or delayed or absent femoral pulses indicative of?

Aorta coarctation

6

What is increase in serum creatinine concentration after starting ACE inhibitors indicative of?

Renal artery stenosis

7

What indicates thyroid disorders?

Brady/tachycardia
Cold/heat intolerance
Constipation/diarrhea

8

What does hypokalemia indicate?

Aldosteronism

9

What are the obstructive sleep apnea symptoms?

Apneic events during sleep
Daytime sleepiness
Snoring

10

What are pheochromocytoma symptoms?

Headaches
Orthostatic hypotension
Palpitations
Sweating
Syncope
Flushing

11

What are Cushing syndrome symptoms?

Buffalo hump
Central obesity
Moon face
Striae

12

Most common cause of secondary hypertension in children/adolescents?

Renal parenchymal disease
Coarctation of the aorta

13

Percentage of children with hypertension that have a secondary cause?

70-85%

14

Adolescents:

10-15%

15

Young adults:

5%

16

Middle-aged adults:

8-12%

17

Older adults:

17%

18

Most common cause of secondary hypertension in young adults?

Thyroid dysfunction
Fibromuscular dysplasia
Renal parenchymal disease

19

Most common cause in middle-aged adults?

Aldosteronism
Thyroid dysfunction
OSA
Cushing syndrome
Pheochromocytoma

20

Most common cause in older adults?

Atherosclerotic renal artery stenosis
Renal failure
Hypothyroidism

21

Statistics of coarctation of the aorta:

Coarctation is 2nd most common cause in children
2-5x more common in boys
Presents as CHF in neonates
Typical diagnosis around 5 years old
Rarely presents in adults

22

What is fibromuscular dysplasia and what does it typically affect?

Narrowing of the artery typically the renal arteries decreasing renal perfusion

23

What is a sign of renal fibromuscular dysplasia?

High-pitched holosystolic renal artery bruit

24

Fibromuscular dysplasia is the most common cause of secondary HTN in which age group?

Young adults

25

What is primary aldosteronism?

Hyperaldosteronism

26

Most common cause of resistant HTN?

Aldosteronism

27

What should lead you to suspect renal artery stenosis?

Development of HTN after age 50
Known atherosclerosis elsewhere
Unexplained renal insufficiency
Rapid deterioration of the kidneys