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Evaluation of Secondary Hypertension

This Harvard Medical School Continuing Education video examines these key questions: Why is understanding secondary hypertension important? What underlying medical conditions, medications, or substances cause secondary hypertension? How do you evaluate patients for secondary hypertension? Dr. Michael Honigberg, MD, a cardiologist at Massachusetts General Hospital, explains how recognizing causes of and contributors to secondary hypertension is helpful for comprehensively evaluating and managing patients. Common medications that can raise blood pressure are identified as are other common causes of secondary hypertension. Diagnostic tests and tools are reviewed and appropriate management for secondary hypertension is identified depending on its cause. This video was peer reviewed by Dr. Jonathan Salik, TMD, MHPEd, Instructor of Medicine, Massachusetts General Hospital; and Dr. Sugantha Sundar, MD, Assistant Professor of Anesthesia, Beth Israel Deaconess Medical Center, to validate the quality and accuracy of the content. 00:00 | Introduction 00:33 | Distinguishing between primary and secondary hypertension 01:41 | Medication classes that can raise blood pressure 01:41 | Common medication classes that can raise blood pressure 02:20 | Other secondary causes of hypertension 04:42 | Patient evaluation 07:09 | Management of secondary hypertension Management of secondary hypertension References: Vitarello JA, Fitzgerald CJ, Cluett JL, Juraschek SP, Anderson TS. Prevalence of Medications That May Raise Blood Pressure Among Adults With Hypertension in the United States. JAMA Intern Med. 2022;182(1):90-93. doi:10.1001/jamainternmed.2021.6819. Brown JM, Siddiqui M, Calhoun DA, et al. The Unrecognized Prevalence of Primary Aldosteronism: A Cross-sectional Study. Ann Intern Med. 2020;173(1):10-20. doi:10.7326/M20-0065 Whelton PK, Carey RM, Aronow WS, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Hypertension 2018;71(6):e136-e139. Notice: At this time, the content in this video is not accredited.