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Tests for the secondary arterial hypertension While most forms of hypertension in humans have no known underlying cause (essential hypertension or primary hypertension), about 10% of the cases, there is a known cause, and thus the hypertension is secondary hypertension Or the high blood pressure is a result of another condition, such as kidney disease or tumours (pheochromocytoma and paraganglioma) Secondary hypertension is more common in preadolescent children, with most cases caused by renal disease. Types Hypertension secondary to other renal disorders Chronic renal failure Kidney disease / renal artery stenosis the normal physiological response to low blood pressure in the renal arteries is to increase cardiac output (CO) to maintain the pressure needed for glomerular filtration. Here, however, increased CO cannot solve the structural problems causing renal artery hypotension, with the result that CO remains chronically elevated. Renal segmental hypoplasia Also known as Ask-Upmark kidney- kidney with a partially developed or atrophic renal cortex Hypertension secondary to endocrine disorders Pheochromocytoma a neuroendocrine tumor of the medulla of the adrenal glands (esp chromaffin cells), or extraadrenal chromaffin tissue that failed to involute after birth and secretes excessive amounts of catecholamines, usually epinephrine and norepinephrine Hyperaldosteronism (Conn's syndrome) Cushing's disease Hyperparathyroidism Acromegaly Hyperthyroidism Hypothyroidism Other secondary hypertension Obstructive sleep apnea Liquorice (when consumed in excessive amounts) Scleroderma Neurofibromatosis Pregnancy Tests for the secondary arterial hypertension Cancers tumours in the kidney can operate in the same way as kidney disease. More commonly, however, tumors cause inessential hypertension by ectopic secretion of hormones involved in normal physiological control of blood pressure. Drugs In particular, alcohol, nasal decongestants with adrenergic effects, NSAIDs, MAOIs, adrenoceptor stimulants, and combined methods of hormonal contraception (those containing ethinyl-estradiol) can cause hypertension while in use. Malformed aorta, slow pulse - these cause reduced blood flow to the renal arteries Aortic valve disease Coarcation of the aorta Anemia Fever Diagnosis The ABCDE mnemonic can be used to help determine a secondary cause of hypertension A: Accuracy, Apnea, Aldosteronism B: Bruits, Bad Kidney C: Catecholamines, Coarctation of the Aorta, Cushing's Syndrome D: Drugs, Diet E: Erythropoietin, Endocrine Disorders Laboratory Tests Urinalysis Eg; Creatinine (renal function) – for chronic renal disease to identify both underlying renal disease as a cause of hypertension and conversely hypertension causing onset of kidney damage. Complete blood count Blood chemistries (potassium, sodium, creatinine, fasting glucose) Fasting lipid profile (LDL, HDL, triglycerides, total cholesterol) ABPM (ambulatory blood pressure monitoring) (in the routine evaluation and management of children with hypertension) http://en.wikipedia.org/wiki/Secondary_hypertension Testing of urine samples for proteinuria For other underlying kidney disease or evidence of hypertensive renal damage. Electrocardiogram (EKG/ECG) for evidence of the heart being under pressure from working against a high blood pressure. Also may show resulting thickening of the heart muscle (left ventricular hypertrophy) or of the occurrence of previous silent cardiac disease (either subtle electrical conduction disruption or even a myocardial infarction). Chest X-ray - again for signs of cardiac enlargement or evidence of cardiac failure. http://www.acupuncture.com.au/education/conditions/hypertension.html http://www.themetaboliccenter.com/hypertension-diagnosis.php Tests for the secondary arterial hypertension Source : Wikipedia & answers.com Ismail bin Sahari , 3051 PAGIARISM SOURCES: 16.7%, DOOPRAVDY: PŘES 50%