Rivas Ana M, Pena Camilo, Kopel Jonathan, Dennis Jeff A, Nugent Kenneth
Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas, U.S.A..
Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas, U.S.A.
Am J Med Sci. 2021 Jan;361(1):3-7. doi: 10.1016/j.amjms.2020.08.012. Epub 2020 Aug 10.
Hypertension can cause significant morbidity and reduced life expectancy. Most patients with hypertension have primary hypertension; however, 10 to 15% of patients have secondary hypertension. Endocrine disorders explain approximately 10% of hypertension in all patients, and thyroid disorders account for approximately 1% of cases with hypertension. Hyperthyroidism can cause increased cardiac output, increased systolic blood pressures, and increased levels of renin, angiotensin, and aldosterone. Treatment of hyperthyroidism can cure hypertension in some patients. Consequently, identification of patients with secondary hypertension potentially has important benefits, and understanding secondary hypertension provides a framework for investigating the pathophysiology of hypertension. Clinicians should consider the possibility of hyperthyroidism in patients with hypertension, even in those of more advanced age.
高血压可导致严重的发病率并缩短预期寿命。大多数高血压患者患有原发性高血压;然而,10%至15%的患者患有继发性高血压。内分泌失调约占所有高血压患者的10%,甲状腺疾病约占高血压病例的1%。甲状腺功能亢进可导致心输出量增加、收缩压升高以及肾素、血管紧张素和醛固酮水平升高。治疗甲状腺功能亢进可治愈部分患者的高血压。因此,识别继发性高血压患者可能具有重要益处,了解继发性高血压为研究高血压的病理生理学提供了一个框架。临床医生应考虑高血压患者存在甲状腺功能亢进的可能性,即使是年龄较大的患者。