Most hypertension (> 90%) is primary, but a subset is secondary to a renal, renovascular or endocrine cause. Correction of the underlying condition may be associated with reversal in the hypertension.


Findings suggestive of secondary hypertension:

(1) age of onset < 30 or > 55 years of age

(2) abrupt onset, with severe hypertension

(3) hypertension resistant to standard medical therapy

(4) unprovoked hypokalemia

(5) abdominal bruit and/or diffuse atherosclerosis

(6) renal damage caused by ACE inhibitors

(7) labile hypertension associated with episodes of sweats, tremors and headache

(8) family history of renal disease

(9) palpable polycystic kidneys

(10) target organ damage involving the heart, kidney or ocular fundus soon after onset


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