Secondary hypertension as a cause of treatment resistance

Key messages The prevalence of secondary hypertension is 5-10% of hypertensive patients (lower in the whole population, higher in patients with therapy-resistant hypertension). Patient history, physical examination, and laboratory results are very important to patients with suspected secondary hypertension to identify. After a preliminary screening, the assignment is made recommended for specialist medical clarification. Think about secondary hypertension In young patients, individuals without a family history of hypertension, late onset of hypertension or worsening of a previous well-controlled hypertension as well as in patients who have a difficult to treat hypertension. In secondary hypertension, elevated blood pressure is caused by a known and/or potentially treatable underlying disease. Although the prevalence of secondary hypertension depends on the patient population and the thoroughness of applied diagnostic approaches, arterial hypertension is classified in 90 to 95% as primary in nature. In young patients, individuals without a family history of hypertension, late onset of hypertension or worsening of a previous well-controlled hypertension as well as in patients who have a difficult to treat hypertension, the prevalence of secondary hypertension is significantly higher. Because the identification and the specific therapy of secondary hypertension may result in normalisation or improvement of elevated blood pressure in many cases, a targeted diagnostics is of great importance.