Secondary Hypertension Overview and Workup for the Primary Care Physician

Turner, Jeffrey M.; Dmitriev, Mikhail

doi:10.1016/j.mcna.2023.03.010

Cited by 1 publication

(4 citation statements)

References 13 publications

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“…Other rare factors that can lead to intraoperative hypertension are secondary causes of hypertension. These factors can be present in 5-10% of all patients diagnosed with hypertension and may be a cause of intraoperative resistant hypertension 13 . Various reasons, including obstructive sleep apnea syndrome, renovascular diseases, and primary aldosteronism can contribute to secondary hypertension 3,13 .…”

Section: Discussionmentioning

confidence: 99%

“…These factors can be present in 5-10% of all patients diagnosed with hypertension and may be a cause of intraoperative resistant hypertension 13 . Various reasons, including obstructive sleep apnea syndrome, renovascular diseases, and primary aldosteronism can contribute to secondary hypertension 3,13 . In our case, the finding of a RI of 0.83 in the bilateral renal artery color Doppler ultrasound performed in the postoperative period raised the possibility that renal artery stenosis could be the cause of intraoperative hypertension in this case.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…In renovascular hypertension, a common cause of secondary hypertension in adults, the underlying reason is often stenosis in the renal arteries, typically associated with atherosclerosis 13,14 . Stenosis in the renal arteries leads to decreased renal blood flow and activation of the reninangiotensin-aldosterone system, causing the development of hypertension 13,14 . In our case, considering the timing of the onset of elevated blood pressure (at the start of partial bypass), a sudden decrease in renal blood flow leading to the activation of the renin-angiotensin-aldosterone system due to underlying stenosis may have contributed to the severity of the condition.…”

Section: Discussionmentioning

confidence: 99%

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Acute and Resistant İntraoperative Hypertension during Mitral Valve Replacement: A Case Presentation

Sert,

Yargı,

Özdemir

et al. 2024

MRAJ

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Background: Intraoperative hypertension continues to be a significant cause of morbidity and mortality for patients undergoing surgery. In this case presentation, an instance of sudden, unexpected, and resistant hypertension during surgery will be discussed in a patient who underwent mitral valve replacement. Case report: A 75-year-old patient with known coronary artery disease and advanced mitral stenosis underwent mitral valve replacement surgery. During the intraoperative process, after the completion of cannulation procedures and transitioning to partial bypass, a sudden increase in blood pressure was observed in the patient. Blood pressure was only brought under control through the intravenous administration of a triple antihypertensive agent. Upon postoperative evaluation following a smooth completion of the surgery and discharge, findings suggested that the cause of the hypertension in the patient might be renovascular hypertension. Conclusions: Intraoperative hypertension, when unexpected and sudden, can lead to an increase in mortality and morbidity. During the intraoperative process, efforts should be made to identify the underlying causes promptly, and appropriate interventions should be carried out. In the postoperative period, patients should be thoroughly evaluated for underlying reasons.

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Section: Discussionmentioning

confidence: 99%