A Textbook on Endocrine Hypertension: Your Key for Better Understanding

Abstract

Hypertension is one of the most common chronic non-communicable diseases affecting 30-40% of the adult population worldwide, and according to the 2021 estimate of the World Health Organisation (WHO), 1.28 billion adults aged between 18 and 79 years are affected globally. The majority (≈85%) of these patients suffer from primary or essential hypertension where there is no underlying cause. The remainder has secondary hypertension caused by one of the several known conditions which may be potentially curable by appropriate timely diagnosis and management. Secondary hypertension often presents as resistant hypertension - defined as blood pressure that remains above 140/90 mmHg despite the use of three antihypertensive medications of different classes at the maximally tolerated doses, one of which is a diuretic1. Approximately 10% of patients treated for hypertension have resistant hypertension1. The prevalence of secondary hypertension is around 30% in patients with resistant hypertension, whereas its prevalence is only 5-15% in non-selected hypertensive population2. Hence, it is important that patients with resistant hypertension undergo workup to identify a potential secondary cause3. The prevalence of secondary hypertension in patients with hypertension under the age of 40 years is close to 30%4. This high prevalence necessitates a systematic work-up for secondary hypertension in young adults, even outside the resistant hypertension range.