SECONDARY HYPERTENSION-RENOVASCULAR HTN

SUMMARY

1. Renovascular HTN (renal artery stenosis and fibromus­cular dysplasia) causing secondary hyperaldosteronism is the most common cause of secondary HTN.

2. Consider renovascular HTN in patients < 30 years of age (fibromuscular), onset of HTN in patients > 55 years of age (atherosclerotic), HTN + unexplained hypokalemia, accelerated HTN.

3. Combination of a continuous abdominal bruit and hypo­kalemia in a hypertensive patient is strongly suggestive of renovascular HTN.

4. Investigate with Doppler US, CT angiography. DSA is gold standard, but invasive.

5. Do not screen elderly patients with mild hypertension and a normal serum potassium.

Reference(s)

Wilkinson, I. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].