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September 24, 2021 01:00pm
By Abimbola Farinde, PhD, PharmD
Screening for underlying causes of high blood pressure can save lives, authors say.
The Endocrine Society has issued a new scientific statement on identifying the underlying causes of high blood pressure that can effectively be treated with medication or cured through surgery.
Hypertension accounts for 1 of 4 American adults, 15% of which, the high blood pressure is caused by hormone, kidney, or other disorders. According to the scientific statement, the rate can be as high as 50% among children and 30% among young adults.
“Without appropriate lab tests, some common endocrine disorders are nearly indistinguishable from a routine case of hypertension,” said former president of the Endocrine Society William F. Young, Jr, MD, MSc, who is also chair of the task force that authored the scientific statement. “Screening for underlying causes of high blood pressure can save lives. This new resource offers health care providers valuable guidance on when to suspect a hormone disorder and how to test for it.”
The absence of effective screening can allow common hormonal causes of high blood pressure, such as primary aldosteronism, to go undiagnosed and untreated. Individuals with these conditions are at a greater risk of developing cardiovascular disease, renal disease resulting in dialysis, or even death.
Hypertensioncan be the first sign of any of the 15 endocrine disorders. Potential causes include tumors that produce adrenal hormones such as aldosterone and adrenaline, thyroid disorders, obstructive sleep apnea, or acromegaly.
The most common endocrine cause of hypertension is primary aldosteronism, which occurs when the adrenal glands produce too much of the hormone aldosterone. When this occurs, it causes a build-up of aldosterone, which normally balances blood levels of sodium and potassium. The excess sodium can result in an increase in blood pressure levels.
The Society’s Clinical Practice Guideline on management of primary aldosteronism estimates that as many as 1 of every 10 individuals with high blood pressure have this condition. Patients with primary aldosteronism have an increased risk of cardiovascular problems including stroke and death, compared with those who have similar blood pressure levels that are not caused by the underlying endocrine condition.
“Health care providers should consider primary aldosteronism screening for most people who have hypertension,” Young said. “This condition can be easily treated and often cured when it is diagnosed. Early detection also reverses the elevated risk of cardiovascular events and kidney failure in this population.”