ACTA ENDOCRINOLOGICA (BUC)

The possibility that a patient with newly diagnosed hypertension has an underlying cause that is directly responsible for the increased blood pressure deserves more attention from clinicians than is currently the case. This limited attention and consideration is responsible for delaying and even missing the diagnosis and proper treatment of secondary hypertension. The reasons are manifold, varying from minimal knowledge of diagnostic tests to easy and low threshold in prescription of antihypertensive drugs. In addition there is the misconception that the prevalence of secondary hypertension is so low that it hardly needs any consideration. However, some forms of secondary hypertension are much more prevalent than previously thought and this applies in particular to endocrine hypertension. In addition, in recent years there are emerging new scientific developments in the field of endocrine hypertension, varying from pathogenesis, genetics, and therapeutics. It is therefore quite remarkable that endocrinologists seem to have hardly any interest in endocrine hypertension, unless there is a clear cut case such as a patient with an already diagnosed pheochromocytoma. They leave the analysis of hypertension to other specialists who have hardly any expertise in for instance the analysis of patients suspected to have primary or pseudo-aldosteronism. The contribution of endocrinology is however essential, not only for detecting more patients with concealed endocrine hypertension but also for optimizing the understanding of the pathogenesis and treatment of high blood pressure in the larger group of patients with primary hypertension.