[Differential diagnosis and therapy of secondary hypertension (with special reference to renal artery stenosis) in general practice]. / Praxisbezogene Differentialdiagnose und Therapie der sekundären Hypertonie (unter besonderer Berücksichtigung der Nierenarterienstenose).

ABSTRACT

Secondary hypertension is present in 3-5% of patients suffering from high blood pressure. Some of the causes of secondary hypertension can be cured and all of them need specific treatment. This can only be provided when an accurate diagnosis is sought. On the other hand, adequate knowledge of the different etiologies and their respective clinical presentation avoids unnecessary and expensive laboratory and imaging investigations. Renal artery stenosis is increasingly being recognised as a relevant and frequent cause of secondary hypertension and renal insufficiency, this previously underdiagnosed entity is thus covered in some detail. Endocrine causes of secondary hypertension are discussed, their diagnosis and treatment should be discussed with an endocrinologist. Before diagnosing hypertension as being refractory to therapy, adequate treatment and patient-compliance have to be enforced. Some frequently overseen but important causes of hypertension in daily practice are also discussed (drug-induced, loss of vessel wall elasticity in old age, etc.).