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Etiology

Etiology. Primary hypertension 95% of all cases Secondary hypertension 5% of all cases Chronic renal disease – most common White coat hypertension Common? Caused by  vascular resistance Harmless??. Causes of secondary hypertension:. Renal: Chronic parenchymal diseases (3-5%).

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Etiology

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  1. Etiology • Primary hypertension • 95% of all cases • Secondary hypertension • 5% of all cases • Chronic renal disease – most common • White coat hypertension • Common? • Caused by  vascular resistance • Harmless??

  2. Causes of secondary hypertension: • Renal: Chronic parenchymal diseases (3-5%). • Renal artery stenosis (1-2%).

  3. Causes of secondary hypertension: • Endocrinal: • Primary hyper aldosteronism< 0.3%. • Pheochromocytoma <0.3%. • Hypo or hyperthyroidism . • Cushing syndrome.

  4. Causes of secondary hypertension: • Aortic coartication. • Drug induced. • Pregnancy.

  5. Aim of evaluation: • Establishment of diagnoses. • Assessment of CV risk. • Evaluation of TOD. • Diagnoses of secondary hypertension.

  6. Patient Evaluation Assess lifestyle and identify other CV risk factors or concomitant disorders: • Hypertension • Smoking • Obesity • Physical inactivity • Dyslipidemia • Diabetes

  7. Assess lifestyle and identify other CV risk factors or concomitant disorders • Microalbuminuria or GFR < 60 ml/min • Age • Males > 55 yrs • Females > 65 yrs • Family history of CVD • Males < 55 yrs • Females < 65 yrs

  8. Patient Evaluation Reveal identifiable causes of hypertension: • Sleep Apnea • Drug-induced • Chronic kidney disease • Primary aldosteronism • Renal vascular disease

  9. Reveal identifiable causes of hypertension: • Chronic steroid therapy and Cushing’s syndrome • Pheochromocytoma • Coarctation of the aorta • Thyroid or parathyroid disorders

  10. Patient Evaluation Assess the presence or absence of target organ damage and CVD • Heart • LVH or CHF • Angina or prior MI • Prior coronary revascularization • Brain • Stroke or transient ischemic attack (TIA)

  11. Assess the presence or absence of target organ damage and CVD • Chronic kidney disease • Peripheral arterial disease • Retinopathy

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