Major Clinical Considerations for Secondary Hypertension and Treatment Challenges: Systematic Review

Abstract

Introduction: In this context, secondary arterial hypertension (SH) is defined as an increase in systemic arterial pressure (SAP) due to an identifiable cause. Only 5 to 10% of patients suffering from hypertension have a secondary form, while the vast majorities have essential hypertension. Objective: This study aimed to describe, through a systematic review, the main considerations on secondary hypertension, presenting its clinical data and main causes, as well as presenting the types of treatments according to the literary results. Methods: Following the criteria of literary search with the use of the Mesh Terms that were cited in the item below on Search strategies, the total of 76 papers that were submitted to the eligibility analysis were collated and, after that, 23 studies were selected, following the rules of systematic review-PRISMA. In general, as an example, the search strategy in MEDLINE / Pubmed, Web of Science, ScienceDirect Journals (Elsevier), Scopus (Elsevier), OneFile (Gale). Major findings: According to epidemiological data, secondary hypertension (SH) presents an incidence of 5.0 to 10.0% of the world population. In this context, since SH cases are difficult to screen and expensive, only patients with clinical suspicion should be examined. In recent years, some new aspects have gained importance in relation to this screening. Thus, increasing evidence suggests that 24-hour ambulatory blood pressure monitoring plays a central role. The prevalence of SH is related to age and clinical characteristics. In addition, some residual hypertension remains after the pathogenic cause of secondary hypertension has been identified and removed because of the existence of essential hypertension. Conclusion:It was concluded with the present study that secondary hypertension effects on average 7.5% of hypertensive patients. Screening in the diagnosis of secondary hypertension is expensive and laborious and should be performed only in patients with high clinical suspicion.