Case of the Month #20 - hypertension

Published 01/02/2022

What are the common causes of secondary hypertension?

Presentation commonly in those <18 years old:

  • Coarctation of the aorta
  • Congenital renal parenchymal disease e.g. Polycystic Kidney Disease
  • Genetic syndromes e.g. Liddle syndrome, 11β-dehydrogenase deficiency

Presentation most common in those 19-40 years old:

  • Renal artery stenosis secondary to fibromuscular dysplasia (especially women)
  • Pre-eclampsia
  • Medications e.g. stimulants (amphetamine, cocaine), nasal decongestants (phenylephrine), OCP, diet pills

Presentation most common in those >40 years old:

  • Phaeochromocytoma (possibly in conjunction with neurofibromatosis, MEN2a /2b or Von-Hippel Lindau syndrome)
  • Obstructive sleep apnoea
  • Cushing’s syndrome
  • Atherosclerotic renal artery stenosis
  • Acquired renal parenchymal disease e.g. diabetes, glomerulonephritis etc.
  • Conn’s disease (primary hyperaldosteronism)
  • Hyperthyroidism