Endocrine Abstracts

Introduction: Secondary high blood pressure is commonly diagnosed in young patients. In recent years, hypertension is increasing as well as the other components of metabolic syndrome such as obesity. The aim of this study was to determine the etiology of hypertension in patients aged <40 years old admitted in an endocrinology department.

Materials and methods: It was a retrospective study including 55 patients <40 years old hospitalized at the endocrinology department between 2003 and 2015 for exploration of a high blood pressure. Patients with cardiac or known renal failure were not enrolled. Epidemiological characteristics, clinical signs of secondary hypertension and biological data were recorded.

Results: The mean age at diagnosis of hypertension was 27.7±7.4 years. Sex ratio (M/F) was 1.2. The mean duration of hypertension was 25.2±43.1 months. 56.1% of patients had severe hypertension. There was a family history of hypertension in 72.7% of cases. Twenty percent patients had prediabetes or diabetes, 30.9% had dyslipemia and 81.8% had overweight. The triad of pheochromocytoma was observed in 18.1%. Cushing syndrome clinical signs were observed in 12.7%. Endocrine causes of hypertension were found in 25.5%: Cushing syndrome in 5.5%, pheochromocytoma in 5.5%, primary hyperaldosteronism in 14.5% (six cases of Conn syndrome and two cases of adrenal hyperplasia) and secondary hyperaldosteronism in 3.6%: One patient had an hypoplasia of thoracic aorta. Renal artery ultrasound was performed in 47.2% of cases. No renal artery stenosis was observed. The etiology of hypertension remained unknown in 70.9% of cases. The rate of secondary hypertension was no different between patients with overweight and those without overwieight (P=0.11).

Conclusion: Prevalence of secondary hypertension in our study was 29.1%. Primary hyperaldosteronism was the most frequent cause. Obesity should not dispense from the exploration of secondary hypertension in youth population.