BACKGROUND The prevalence of secondary causes of hypertension in young adults is unknown, and therefore, there is no consensus about the indication of screening of secondary hypertension (2HTN) in this population. The objective was to report the prevalence and the causes of 2HTN in young subjects. METHODS In this cross-sectional study, 2090 patients with confirmed hypertension aged 18 to 40 years with full workup for 2HTN screening were included. We assessed the prevalence of 2HTN and analyzed the factors associated. RESULTS Among 2090 patients, 619 (29.6%) had a 2HTN. The most frequent diagnoses of 2HTN in descending order were primary aldosteronism (n=339; 54.8%), renovascular hypertension (n=114; 18.4%), primary kidney disease (n=80; 12.9%), pheochromocytoma/functional paraganglioma (n=37; 5.9%), hypertension caused by drugs or substances (n=32; 6.0%), and other diagnoses (n=17; 2.7%). Patients with blood pressure <160/100 mm Hg did not have a lower prevalence of 2HTN regardless of the number of treatments. The prevalence of 2HTN was higher in the decade between 30 and 40 years of age than between 18 and 30 years of age (P=0.024). Female sex, hypokalemia, treatment with at least 2 medications, no familial history of hypertension, body mass index <25 kg/m², and diabetes were associated with a higher prevalence of 2HTN. CONCLUSIONS The prevalence of 2HTN is high among young patients with hypertension (29.6% in our cohort), regardless of age and blood pressure level. All patients with hypertension under 40 years of age should be screened for secondary causes.

中文翻译：

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年轻人继发性高血压的患病率和危险因素。


背景 年轻人高血压继发性原因的患病率尚不清楚，因此，对于该人群中继发性高血压 （2HTN） 筛查的适应症尚未达成共识。目的是报告年轻受试者 2HTN 的患病率和原因。方法 在这项横断面研究中，纳入了 2090 例确诊高血压的患者，年龄在 18 至 40 岁之间，并进行了 2HTN 筛查的全面检查。我们评估了 2HTN 的患病率并分析了相关因素。结果 在 2090 例患者中，619 例 （29.6%） 患有 2HTN。2HTN 最常见的诊断按降序排列为原发性醛固酮增多症 （n=339;54.8%）、肾血管性高血压 （n=114;18.4%）、原发性肾病 （n=80;12.9%）、嗜铬细胞瘤/功能性副神经节瘤 （n=37;5.9%）、药物或物质引起的高血压 （n=32;6.0%） 和其他诊断 （n=17;2.7%）。无论治疗次数如何，血压 <160/100 mm Hg 患者的 2HTN 患病率都没有降低。2HTN 的患病率在 30 至 40 岁之间的十年中高于 18 至 30 岁之间的患病率 （P=0.024）。女性、低钾血症、至少 2 种药物治疗、无高血压家族史、体重指数 <25 kg/m² 和糖尿病与 2HTN 患病率较高相关。结论 无论年龄和血压水平如何，年轻高血压患者 2HTN 的患病率都很高 （在我们的队列中为 29.6%）。所有 40 岁以下的高血压患者都应筛查继发性原因。