New Recommendations Issued for Endocrine Hypertension Screening

A new Scientific Statement offers guidance to healthcare providers on ways to identify underlying hormonal causes of high blood pressure, particularly conditions that can be cured with surgery or treated effectively with medication.

The Scientific Statement was issued by the Endocrine Society (Washington, DC, USA) as a resource to improve detection of curable forms of hypertension. Without effective screening, common hormonal causes of high blood pressure often go undiagnosed and untreated. This can leave individuals with these conditions at greater risk of developing cardiovascular or renal disease.

“Without appropriate lab tests, some common endocrine disorders are nearly indistinguishable from a routine case of hypertension,” said William F. Young, Jr, MD, MSc, of Mayo Clinic (Rochester, MN, USA), and chair of the task force that authored the Statement, “Screening for underlying causes of high blood pressure can save lives. This new resource offers healthcare providers valuable guidance on when to suspect a hormone disorder and how to test for it.”

Hypertension can be the first sign of any of 15 known endocrine disorders. The endocrine system produces and controls hormones. Potential causes of hypertension can include tumors that produce adrenal hormones (e.g. aldosterone and adrenaline), thyroid disorders, or acromegaly (where excess growth hormone builds up in the bloodstream), obstructive sleep apnea. The Statement advises on the screening process for, and delves into the number of people affected by, the 15 endocrine disorders.

The most common endocrine cause of hypertension is primary aldosteronism, which occurs when the adrenal glands produce too much aldosterone. The resulting buildup of aldosterone (which normally helps balance blood levels of sodium and potassium) results in excess sodium that can raise blood pressure. As many as 1 in 10 people with hypertension may have this condition, according to the Society’s Clinical Practice Guideline on management of primary aldosteronism.

“Healthcare providers should consider primary aldosteronism screening for most people who have hypertension,” said Dr. Young, “The condition can be easily treated and often cured when it is diagnosed. Early detection also reverses the elevated risk of cardiovascular events and kidney failure in this population.”

The statement, by Young WF et al, was published April 5, 2017, in the journal Endocrine Reviews.