Approach to a young patient with hypertension

General Evaluation - History and Examination, Basic chemistries (K, eGFR), Urinalysis

Renal Imaging (parenchyma + vasculature)

Plasma aldosterone and renin activity (evaluate based on profile)

   ↑AIdo/↑PRA: Secondary HA (malignant HTN, RAS, CoAo, large vessel vasculopathies, reninoma)

   ↑AIdo/↓PRA: Primary HA (adenoma, hyperplasia, GRA, carcinoma)

   ↓AIdo/↓PRA: Cushing, CAH, AMES, Liddle, low-renin essential HTN

If work-up unrevealing: Consider sleep apnea, thyroid disease, hyperparathyroidism, pheochromocytoma, primary CNS disease



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