Endocrine Society Issues Scientific Statement to Improve Detection of Curable Forms of Hypertension

A new Scientific Statement issued by the Endocrine Society advises healthcare providers on ways to spot hormonal causes of hypertension that can be cured with surgery or treated effectively with medication.

Without effective screening, common hormonal causes of hypertension, such as the disorder termed “primary aldosteronism,” often go undiagnosed and untreated. This can leave individuals with these conditions at greater risk of developing cardiovascular disease, renal disease leading to dialysis, or even death.

“Screening for underlying causes of high blood pressure can save lives. This new resource offers healthcare providers valuable guidance on when to suspect a hormone disorder and how to test for it.”

Hypertension affects one in four American adults, according to the Scientific Statement. In about 15% of these cases, hypertension is caused by hormone, kidney, or other disorders. The rate can be as high as 50% among children and 30% among young adults.

“Without appropriate lab tests, some common endocrine disorders are nearly indistinguishable from a routine case of hypertension,” says Endocrine Society Past President William F. Young, Jr., MD, MSc, of the Mayo Clinic in Rochester, Minn., and the chair of the task force that authored the Society’s Scientific Statement. “Screening for underlying causes of high blood pressure can save lives. This new resource offers healthcare providers valuable guidance on when to suspect a hormone disorder and how to test for it.”

Hypertension can be the first sign of any of 15 endocrine disorders. Potential causes of high blood pressure can include tumors that produce adrenal hormones such as aldosterone and adrenaline, thyroid disorders, obstructive sleep apnea, or acromegaly. The Scientific Statement delves into the number of people affected by the 15 endocrine disorders and the screening process for these disorders.

The most common endocrine cause of high blood pressure is primary aldosteronism, which occurs when the adrenal glands produce too much of the hormone aldosterone. This causes a build-up of aldosterone, which normally balances blood levels of sodium and potassium. The resulting excess sodium can raise blood pressure levels.

As many as one in 10 people with high blood pressure may have this condition, according to the Society’s Clinical Practice Guideline on management of primary aldosteronism. Individuals with primary aldosteronism face an increased risk of cardiovascular problems, including death and stroke, compared to individuals who have similar blood pressure levels that are not caused by an underlying endocrine condition.

“The condition can be easily treated and often cured when it is diagnosed. Early detection also reverses the elevated risk of cardiovascular events and kidney failure in this population.”

“Healthcare providers should consider primary aldosteronism screening for most people who have hypertension,” Young says. “The condition can be easily treated and often cured when it is diagnosed. Early detection also reverses the elevated risk of cardiovascular events and kidney failure in this population.”

Other authors of the statement include: David A. Calhoun, University of Alabama at Birmingham, Birmingham, Ala.; Jacques W.M. Lenders, Radboud University Medical Centre, Nijmegen, the Netherlands, and University Hospital Carl Gustav Carus, Technische Universität in Dresden, Germany; Michael Stowasser, University of Queensland School of Medicine, Greenslopes Private Hospital, and Princess Alexandra Hospital, Queensland, Australia; and Stephen C. Textor, the Mayo Clinic, Rochester, Minn.

The statement, “Screening for Endocrine Hypertension: An Endocrine Society Scientific Statement,” was published online in the Society’s journal Endocrine Reviews.

The statement was published in the April issue of Endocrine Reviews.

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