The role of the general practitioner in the diagnostics of endocrine arterial hypertension
https://doi.org/10.15829/1728-8800-2019-2-84-93
Abstract
Arterial hypertension (AH) is observed in almost every third of adult, and in 15% of cases it can be secondary. Endocrine hypertension as a cause of symptomatic hypertension (SAH) takes the second place after renovascular etiology. Thus, screening of endocrine SAH should be performed on almost every patient with AH. The general practitioner first meets a patient with elevated blood pressure levels, and his aim is to suspect SAH just-in-time, be able to provide its primary diagnostics, interpret the results and know the cases when patient with AH should be referred to a narrowly focused specialist. The article presents modern approaches to screening of endocrine hypertension causes, which allow not only to normalize blood pressure, but also to avoid complications.
About the Authors
N. I. Volkova
Rostov State Medical University, of the Ministry of Health of Russia
Russian Federation
Russian Federation
Rostov-on-Don
I. Yu. Davidenko
Rostov State Medical University, of the Ministry of Health of Russia
Russian Federation
Russian Federation
Rostov-on-Don
References
1. Omura M, Saito J, Yamaguchi K, et al. Prospective study on the prevalence of secondary hypertension among hypertensive patients visiting a general outpatient clinic in Japan. Hypertens Res. 2004;27(3):193-202. doi:10.1291/hypres.27.193.
2. Camelli S, Bobrie G, Postel-Vinay N, et al. Prevalence of secondary hypertension in young hypertensive adults. J Hypertens. 2015;33(Suppl 1):e47. doi:101097/01.hjh.0000467473.21331.70.
3. Gupta-Malhotra M, Banker A, Shete S, et al. Essential hypertension vs. secondary hypertension among children. Am J Hypertens. 2015;28(1):73-80. doi:10.1093/ajh/hpu083.
4. Young, WF, Jr, Calhoun DA, Lenders JW, et al. Screening for endocrine hypertension: an endocrine society scientific statement. Endocrine Reviews. 2017;38(2):103-22. doi:10.1210/er.2017-00054.
5. Mancia G, Fagard R, Narkiewicz K, et al. 2013 ESH/ESC guidelines for the management of arterial hypertension: the Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Eur Heart J. 2013;34(28):2159-219. doi:10.1097/01.hjh.0000431740.32696.cc.
6. O'Shea PM, Griffin TP, Fitzgibbon M. Hypertension: the role of biochemistry in the diagnosis and management. Clin Chim Acta. 2017;465:131-43. doi:10.1016/j.cca.2016.12.014.
7. Lenders JW, Eisenhofer G, Mannelli M, et al. Phaeochromocytoma. Lancet. 2005;366(9486):665-75. doi:10.1016/S0140-6736(05)67139-5.
8. Eisenhofer G, Pacak K, Huynh TT, et al. Catecholamine metabolomic and secretory phenotypes in phaeochromocytoma. Endocr Relat Cancer. 2010;18(1):97-111. doi:10.1677/ERC-10-0211.
9. Mansmann G, Lau J, Balk E, et al. The clinically inapparent adrenal mass: update in diagnosis and management. Endocr Rev. 2004;25(2):309-40. doi:10.1210/er.2002-0031.
10. Bravo EL, Tagle R. Pheochromocytoma: state-of-the-art and future prospects. Endocr Rev. 2003;24(4):539-53. doi:10.1097/01.ju.0000152353.64525.a9.
11. Eisenhofer G, Rivers G, Rosas AL et al. Adverse drug reactions in patients with phaeochromocytoma: incidence, prevention and management. Drug Saf. 2007;30(11):1031-62. doi: 10.2165/00002018-200730110-00004.
12. Perry CG, Sawka AM, Singh R, et al. The diagnostic efficacy of urinary fractionated metanephrines measured by tandem mass spectrometry in detection of pheochromocytoma. Clin Endocrinol (Oxf). 2007;66(5):703-8. doi:10.1111/j.1365-2265.2007.02805.x.
13. Lenders JW, Duh QY, Eisenhofer G, et al. Endocrine Society. Pheochromocytoma and paraganglioma: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2014;99(6):1915-42. doi:10.1210/jc.2014-1498.
14. Volkova NI, Porksheyan MI. Diseases of the adrenal glands in adults: diagnostics. Rostov-on-Don: Proffpress, 2015. P. 33. (In Russ.) ISBN 978-5-222-30010-7.
15. Dedov II, Melnichenko GA, editors. Endocrinology. National guide. Short edition. M: Geotar-Media, 2013. P. 752. (In Russ.) ISBN 978-5-9704-2471-1.
16. Rossi GP, Bernini G, Caliumi C, et al. A prospective study of the prevalence of primary aldosteronism in 1,125 hypertensive patients. JACC. 2006;48(11):2293-300. doi:10.1016/j.jacc.2006.07.059.
17. Eide IK, Torjesen PA, Drolsum A, et al. Low-renin status in therapy-resistant hypertension: a clue to efficient treatment. J Hypertens. 2004;22(11):2217-26. doi:10.14341/probl201056341-46.
18. Funder JW, Carey RM, Mantero F, et al. The management of primary aldosteronism: case detection, diagnosis, and treatment: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2016;101(5):1889-916. doi:10.1210/jc.2015-4061.
19. Volkova NI, Porksheyan MI. Clinic and diagnostics of hypercortisolism without specific clinical signs: monograph. Rostov-on-Don: Proffpress, 2017. P. 138. (In Russ.) ISBN 978-5-905468-89-6.
20. Sacerdote A, Weiss K, Tran T, et al. Hypertension in patients with Cushing's disease: pathophysiology, diagnosis, and management. Curr Hypertens Rep. 2005;7(3):212-8. doi:10.1007/s11906-005-0013-4.
21. Nieman LK, Biller BM, Findling JW, et al. The diagnosis of Cushing's syndrome: an Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2008;93(5):1526-40. doi:10.1210/jc.2008-0125.
22. Danzi S, Klein I. Thyroid hormone and blood pressure regulation. Curr Hypertens Rep. 2003;5(6):513-20. doi:10.1007/s11906-003-0060-7.
23. Bahn RS, Burch HB, Cooper DS, et al. Hyperthyroidism and other causes of thyrotoxicosis: management guidelines of the American Thyroid Association and American Association of Clinical Endocrinologists. Endocr Pract. 2011;17(3):456-520. doi:10.1089/thy.2010.0417.
Review
For citations:
Volkova N.I., Davidenko I.Yu. The role of the general practitioner in the diagnostics of endocrine arterial hypertension. Cardiovascular Therapy and Prevention. 2019;18(2):84-93. (In Russ.) https://doi.org/10.15829/1728-8800-2019-2-84-93
Views:
1498
Email this article 
