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Approximately 5% of patients with hypertension are diagnosed with a secondary cause to the condition. The most common causes include renal and renovascular hypertension, which are both clinically characterized by secondary hyperaldosteronism, as well as primary hyperaldosteronism, which is much more common than previously thought. Other endocrinological causes of hypertension are clearly more rare. Exclude secondary aetiology if hypertension is associated with any of the following atypical features: poor response to therapy (therapy goals not reached with three medications) onset before the age of 30 years rapidly increasing blood pressure (BP) at an older age systolic blood pressure over 220 mmHg or diastolic blood pressure over 120 mmHg hypokalaemia increased plasma creatinine concentration proteinuria, or haematuria.
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