Clinical use of laboratory tests for the identification of secondary forms of arterial hypertension.

Abstract:

:The prevalence of secondary hypertension can be underestimated if appropriate tests are not performed. The importance of selecting patients with a high pre-test probability of secondary forms of hypertension is first discussed. The laboratory tests currently used for seeking a cause of hypertension are critically reviewed, with emphasis on their operative features and limitations. Strategies to identify primary aldosteronism, the most frequent form of secondary hypertension, and to determine its unilateral or bilateral causes are described. Treatment entails adrenalectomy in unilateral forms, and mineralocorticoid receptor blockade in bilateral forms. Renovascular hypertension is also a common, curable form of hypertension, that should be identified as early as possible to avoid the onset of cardiovascular target organ damage. The tests for its confirmation or exclusion are discussed. The various tests available for the diagnosis of pheochromocytoma, which is much rarer than the above but extremely important to identify, are also described, with emphasis on recent developments in genetic testing. Finally, the tests for diagnosing some rarer monogenic forms and other renal and endocrine causes of arterial hypertension are explored.

journal_name

Crit Rev Clin Lab Sci

authors

Rossi GP,Seccia TM,Pessina AC

doi

10.1080/10408360600931831

subject

Has Abstract

pub_date

2007-01-01 00:00:00

pages

1-85

issue

1

eissn

1040-8363

issn

1549-781X

pii

N6861165202530K3

journal_volume

44

pub_type

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