Rare Causes of Hypertension

Andrzej Januszewicz; Cezary Szmigielski; Izabela Łoń

Vol 3, No 4 (1999)

Review paper

Published online: 2000-03-09

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Rare Causes of Hypertension

Andrzej Januszewicz, Cezary Szmigielski, Izabela Łoń

Nadciśnienie tętnicze 1999;3(4):251-256.

Vol 3, No 4 (1999)

REVIEV

Published online: 2000-03-09

Abstract

There are some forms of hypertension which despite rare occurrence should be included in the diagnosis of hypertension. Some of them have potentially reversible causes. In some cases early and appropriate treatment allow to avoid dangerous complications. Primary reninism is a potentially reversible cause of severe, secondary hypertension. In the patients with the juxtaglomerular cells tumours increased secretion of renin Leads to increased aldosterone secretion. The surgical resection of the tumour is the treatment of choice. Hemangioendothelioma, a tumour secreting endothelin, which is a potent vasoconstrictor, is a very rare cause of hypertension. Gordon's syndrome is a rare hereditary disorder with hypertension, hyperkaliemia, hyperchloremia and acidemia with normal glomerular filtration rate. Severe hyperkaliemia is the most persistent feature of this syndrome. Glucocorticoid-remediable aldosteronism (GRA) is a hereditary, autosomal dominant disease with hypertension. The treatment with dexamethasone normalises blood pressure and metabolic disturbances. Liddle's syndrome, known as pseudohyperaldosteronism is a rare hereditary, autosomal dominant tubulopathy. Hypertension is caused by an increase in fluid retention and hypervolemia. The treatment of choice is a sodium-depleted diet combined with amiloride or triamteren.