以肾上腺疾病为重点的内分泌性高血压筛查和治疗:叙述性综述。

IF 1 Q3 MEDICINE, GENERAL & INTERNAL Journal of Yeungnam medical science Pub Date : 2024-10-01 Epub Date: 2024-09-19 DOI:10.12701/jyms.2024.00752
Seung Min Chung
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引用次数: 0

摘要

大多数高血压病例无法确定病因,被称为原发性高血压;然而,约有 15%的高血压病例是由继发性病因引起的。原发性醛固酮增多症(PA)和嗜铬细胞瘤及副神经节瘤(PPGL)是具有代表性的内分泌性高血压疾病。鉴别内分泌性高血压为治疗和预防靶器官损害提供了机会。PA 是继发性高血压最常见的病因,与原发性高血压相比,PA 会显著增加心血管疾病的风险;因此,临床表现提示继发性高血压的患者应进行 PA 筛查。PPGL虽然罕见,但一旦误诊就可能致命。PPGL是最常见的遗传性内分泌肿瘤,因此建议使用新一代测序板进行基因检测。在此,我们旨在总结 PA 和 PPGL 的特征性临床症状,以及何时和如何进行诊断测试和治疗策略。
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Screening and treatment of endocrine hypertension focusing on adrenal gland disorders: a narrative review.

Most cases of high blood pressure have no identifiable cause, termed essential hypertension; however, in approximately 15% of cases, hypertension occurs due to secondary causes. Primary aldosteronism (PA) and pheochromocytoma and paraganglioma (PPGL) are representative endocrine hypertensive diseases. The differentiation of endocrine hypertension provides an opportunity to cure and prevent target organ damage. PA is the most common cause of secondary hypertension, which significantly increases the risk of cardiovascular disease compared to essential hypertension; thus, patients with clinical manifestations suggestive of secondary hypertension should be screened for PA. PPGL are rare but can be fatal when misdiagnosed. PPGL are the most common hereditary endocrine tumors; therefore, genetic testing using next-generation sequencing panels is recommended. Herein, we aimed to summarize the characteristic clinical symptoms of PA and PPGL and when and how diagnostic tests and treatment strategies should be performed.

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