Borozan Sanja, Kamrul-Hasan A B M, Shetty Sahana, Pappachan Joseph M
Department of Endocrinology, Clinical Centre of Montenegro, Podgorica, Montenegro.
Faculty of Medicine, University of Montenegro, Podgorica, 81000, Montenegro.
Curr Hypertens Rep. 2025 Jan 16;27(1):8. doi: 10.1007/s11906-025-01323-w.
Hypertension remains a major chronic disease morbidity across the world, even in the twenty-first century, affecting ≈40% of the global population, adversely impacting the healthcare budgets in managing the high incidence of cardiovascular disease (CVD) complications and mortality because of elevated blood pressure (BP). However, evaluation and management of endocrine hypertension are not optimal in clinical practice. With three unique clinical case scenarios, we update the evidence base for diagnostic evaluation and management of endocrine hypertension in this review to inform appropriate day-to-day clinical practice decisions.
Although most individuals with high BP suffer from essential hypertension (≈85%), some patients may have a clear underlying etiology (termed secondary hypertension), and a significant proportion of these patients have endocrine hypertension (≈10%) consequent to hormone excess from dysfunction of one or more endocrine glands. Even if a relatively common disease in the general population, the correct diagnosis and appropriate treatment of endocrine hypertension is often delayed because of poor awareness among clinicians, including primary care providers and physicians in the secondary care settings. An accurate and timely diagnosis of endocrine hypertension is crucial to potentially cure or at least properly manage these patients because the consequences of delays in diagnosis can be catastrophic, with markedly higher end-organ complications such as CVD, chronic kidney disease, and even premature mortality among sufferers.
即使在21世纪，高血压仍然是全球主要的慢性疾病，影响着约40%的全球人口，由于血压升高，对管理心血管疾病（CVD）并发症高发和死亡率的医疗预算产生不利影响。然而，内分泌性高血压的评估和管理在临床实践中并不理想。在本综述中，我们通过三个独特的临床病例场景，更新内分泌性高血压诊断评估和管理的证据基础，为日常适当的临床实践决策提供依据。
虽然大多数高血压患者患有原发性高血压（约85%），但一些患者可能有明确的潜在病因（称为继发性高血压），其中很大一部分患者因一个或多个内分泌腺功能障碍导致激素过多而患有内分泌性高血压（约10%）。即使内分泌性高血压在普通人群中是一种相对常见的疾病，但由于临床医生（包括初级保健提供者和二级保健机构的医生）认识不足，内分泌性高血压的正确诊断和适当治疗往往会延迟。准确及时地诊断内分泌性高血压对于潜在治愈或至少妥善管理这些患者至关重要，因为诊断延迟的后果可能是灾难性的，患者的终末器官并发症（如CVD、慢性肾病）明显更高，甚至会过早死亡。
