Secondary Causes Of Hypertension

Renal Diseases

Parenchymal (glomerulonephritis, polycystic renal disease, diabetic nephropathy) Renovascular


Primary aldosteronism Cushing syndrome Pheochromocytoma Hyperthyroidism

Growth homione excess (acromegaly) Oral contraceptives


Coarctation of the aorta

Increased intravascular volume (posttransfusion) Hypercalcemia

Medications (sympathomimetics, glucocorticoids)

smoking, dyslipidemia, diabetes mellitus, obesity, kidney disease, and a family history of premature cardiovascular disease. Target organ damage of hypertension includes cardiomyopathy, nephropathy, and retinopathy. Although treatment decisions in the management of hypertension depend more upon the blood pressure level (modified perhaps in the presence of diabetes mellitus), the presence of other cardiovascular risk factors and/or evidence of target organ damage may further guide therapy and provide some prognostic information. A complete history and physical examination, including funduscopic examination, auscultation of the major arteries for bruits, palpation of the

Table 9-2

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