Endocrine Hypertension in Children and Adults: Beyond Primary Aldosteronism

Abstract

Endocrine hypertension refers to elevated blood pressure resulting from an identifiable hormonal cause that is potentially treatable. Endocrine hypertension occurs in ∼30% of young adults with hypertension (18-40 years), in 30-50% of patients with resistant hypertension, most commonly due to primary aldosteronism, and can occur in a small yet clinically significant subset of children with hypertension. Other causes of endocrine hypertension include excess mineralocorticoid production, cortisol excess or impaired cortisol metabolism, disorders of the mineralocorticoid receptor or epithelial sodium channel, catecholamine-secreting tumors, thyroid or parathyroid disorders, and growth hormone excess. Early recognition is crucial, as many of these conditions are amenable to targeted medical or surgical therapies. This review focuses on endocrine causes of hypertension in both pediatric and adult populations, excluding primary aldosteronism.

Endocrine hypertension refers to elevated blood pressure resulting from an identifiable hormonal cause that is potentially treatable. Endocrine hypertension occurs in ∼30% of young adults with hypertension (18-40 years), in 30-50% of patients with resistant hypertension, most commonly due to primary aldosteronism, and can occur in a small yet clinically significant subset of children with hypertension. Other causes of endocrine hypertension include excess mineralocorticoid production, cortisol excess or impaired cortisol metabolism, disorders of the mineralocorticoid receptor or epithelial sodium channel, catecholamine-secreting tumors, thyroid or parathyroid disorders, and growth hormone excess. Early recognition is crucial, as many of these conditions are amenable to targeted medical or surgical therapies. This review focuses on endocrine causes of hypertension in both pediatric and adult populations, excluding primary aldosteronism.