22
Evaluation and Diagnosis
Table 10. Causes of Secondary Hypertension With Indications
for Additional Testing and Diagnostic Screening Tests
(cont'd)
Prevalence Indications for Additional Testing
Uncommon causes
Hypothyroidism <1% Dry skin; cold intolerance; constipation;
hoarseness; weight gain
Hyperthyroidism <1% Warm, moist skin; heat intolerance;
nervousness; tremulousness; palpitations,
insomnia; weight loss; diarrhea; proximal
muscle weakness
Pheochromocytoma/
paraganglioma
<0.6% Resistant hypertension; paroxysmal
hypertension or crisis superimposed on
sustained hypertension; "spells," BP lability,
headache, sweating, palpitations, piloerection;
positive family history of pheochromocytoma/
paraganglioma; adrenal incidentaloma
Aortic coarctation
(undiagnosed or
repaired)
0.1% Young adult with hypertension (<30 y)
Cushing syndrome <0.1% Rapid weight gain, especially with central
distribution; proximal muscle weakness;
depression; hyperglycemia
Primary
hyperparathyroidism
Rare Hypercalcemia
