Grimaldi Franco
S.O.C. di Endocrinologia e Malattie del Metabolismo, Azienda Ospedaliero Universitaria ''S. Maria della Misericordia'', Udine, Italy.
G Ital Nefrol. 2010 Sep-Oct;27 Suppl 50:S86-90.
Hypertension is one of the main risk factors for cardiovascular diseases, which today are the primary cause of mortality in developed countries. To decrease the mortality and morbidity due to cardiovascular disease, it is necessary to treat hypertension correctly on the basis of an accurate diagnosis. A secondary cause of hypertension must be suspected if it is severe or resistant to treatment, if there is a sudden increase in blood pressure in a patient hitherto well controlled, or if it develops in childhood or in a person under 30 years of age, especially if not obese and without a family history of hypertension. In these instances the frequency of hypertension varies from 1-5% for mild to moderate to 10-20% for severe or refractory hypertension. One of the principal causes of secondary hypertension is related to adrenal gland tumors or dysfunctions such as Cushing's syndrome, primary aldosteronism (Conn's syndrome) and pheochromocytoma. This paper will discuss the clinical presentation and diagnostic tests pertinent to these neoplasms, organ damage assessment, utilization of imaging techniques, and the medical and surgical options.
高血压是心血管疾病的主要危险因素之一，而心血管疾病如今是发达国家的主要死因。为降低心血管疾病导致的死亡率和发病率，有必要在准确诊断的基础上正确治疗高血压。如果高血压病情严重或对治疗耐药，如果原本血压控制良好的患者血压突然升高，或者高血压在儿童期或30岁以下人群中发生，尤其是非肥胖且无高血压家族史的人，就必须怀疑存在继发性高血压病因。在这些情况下，轻度至中度高血压的发生率为1%至5%，重度或难治性高血压的发生率为10%至20%。继发性高血压的主要病因之一与肾上腺肿瘤或功能障碍有关，如库欣综合征、原发性醛固酮增多症（康恩综合征）和嗜铬细胞瘤。本文将讨论与这些肿瘤相关的临床表现和诊断测试、器官损伤评估、成像技术的应用以及药物和手术治疗选择。
