[Therapy-resistant hypertension--the endocrinological view]

Abstract

A significant percentage of patients with therapy-resistant high blood pressure have hormonal hypertension. This includes primary hyperaldosteronism due to an aldosterone-producing adenoma, or a bilateral adrenal hyperplasia, hypercortisolism caused by a tumor of the adrenals, or an ACTH-dependent form of Cushing's syndrome, as also excessive catecholamines caused by a pheochromocytoma or a paraganglioma. The diagnostic work-up includes screening tests for the basal hormone status in the serum and urine, together with confirmatory additional hormonal and imaging procedures in suspected cases, or to establish a differential diagnosis. In addition to surgical treatment, specific pharmacotherapeutic measures for the prevention or follow-up treatment of excess adrenal hormones are available.