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JCOM Abstract

J Clin Outcomes Manage 
2010 Sep;17(9):423-431
Secondary hypertension: diagnosis and management of an adrenal adenoma
Tagawa M, Cohen DL

Abstract Objective: To review the assessment of secondary hypertension and the management of an adrenal adenoma. Methods: Literature review focusing on recent guide-lines on hypertension (especially resistant hypertension and secondary hypertension), primary aldosteronism, and adrenal adenoma. Original articles were reviewed when indicated. Results: Secondary hypertension should be suspected in selected patients. Primary aldosteronism is more prevalent than previously thought. If suspected, patients should be screened for primary aldosteronism using a plasma aldosterone-to-renin ratio. Adrenal venous sampling plays an important role in deciding whether surgery is an option in the management of adrenal adenoma. The management of atherosclerotic renal artery stenosis should be individualized and percutaneous revascularization should be considered cautiously. Conclusion: It is important to identify patients with secondary hypertension as they often require different management strategies and may have a potentially curable form of hypertension.

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