Nanfang Li - Screening, Diagnosis and Treatment

This Springer imprint is published by the registered company Springer Nature Singapore Pte Ltd.

The registered company address is: 152 Beach Road, #21-01/04 Gateway East, Singapore 189721, Singapore

Hypertension is the most important risk factor for cardiovascular diseases. It remains one of the greatest threats to human health nowadays. Hypertension can be divided into essential hypertension and secondary hypertension. A large number of studies on differential diagnosis have shown an increase in the number of secondary hypertension, and the prevalence of secondary hypertension has increased to over 1015% among the hypertensive population.

However, secondary hypertension is not easy to be diagnosed because of its insidious and complicated causes. Its detrimental effects include not only the final occurrence of cardiovascular and cerebrovascular diseases but also the accompanying damage of target organs caused by hypokalemia, hyperaldosterone, increased cortisol, high renin, and high catecholamine.

The etiology of secondary hypertension includes cardiovascular diseases, endocrine diseases, kidney diseases, sleep medicine, autoimmune diseases, and mental and psychological diseases. Therefore, the screening, diagnosis, and treatment are also a complicated process. Clinicians are required to do careful physical as well as detailed laboratory examinations to finally identify the causes of hypertension and carryout individualized treatment.

The Center of Hypertension of the Peoples Hospital of Xinjiang Uygur Autonomous has been engaged in hypertension clinical work and scientific research for more than 20 years and has a lot of clinical experience on secondary hypertension diagnosis and treatment. The authors completed the bookSecondary Hypertension: Screening, Diagnosis and Treatmentby consulting a large amount of research material combining with the clinical practice and research experiences of the Center. This book is a systematic comprehensive reference book about screening, diagnosis, and treatment of secondary hypertension. It includes the description of the occurrence mechanism, clinical manifestations, diagnosis, and treatment of secondary hypertension, which is helpful for the early diagnosis and treatment of secondary hypertension, and it is a valuable reference book for clinicians, especially professional physicians and researchers who are studying and treating hypertension.

Gratefully acknowledge to Dr. Jina Yili, Ms.Kripa Guruprasad and Ms. Mariesha Justin for their great work in editing and publishing this book.

The high prevalence of hypertension is closely related to cardiovascular and cerebrovascular diseases, which has caused great harm to human health. We know that hypertension can be divided into primary hypertension with unknown causes and unclear pathogenesis and secondary hypertension with clear etiology. Traditionally, secondary hypertension accounts for only 510%. However, with the in-depth study of the etiology of hypertension and the improvement of the clinical diagnostic techniques, the detection rate of secondary hypertension has far exceeded our expectations, for example, obstructive sleep apnea syndrome (OSAS) is one of the most important secondary hypertension, accounting for at least 30% of adults with hypertension. Only a part of primary aldosteronism is combined with hypokalemia, accounting for 515% of patients with hypertension. It could be said that all hypertension has certain causes. As for the so-called essential hypertension, it is not known by us or we are unable to understand the cause. Hypertension is a common clinical manifestation of many disorders and intermediate link in their pathophysiological process. Different hypertension individuals or populations may have different mechanisms, hypertension mechanisms, and the same individual may have multiple blood pressure elevated mechanisms at the same time.

The etiology of secondary hypertension is often hidden and complex, involving cardiovascular diseases, endocrine diseases, kidney diseases, sleep medicine, mental illness, and other disciplines, and at the edge of above disciplines. Due to the intensive clinical division, the number of cases of secondary hypertension that has been reported is much incompatible with the actual prevalence. While the etiological detection and treatment of the secondary hypertension can not only benefit blood pressure control and target organ damage reduction, but also cure hypertension and greatly reduce the patients medical burden through long-term treatment. We can imagine that the individualized treatment of hypertension, including etiological treatment, is the higher field of hypertension treatment.

Therefore, we (Hypertension Center of the Peoples Hospital of Xinjiang Uygur Autonomous Region) have been engaged in the diagnosis and differentiation of secondary hypertension for a long time and successfully screened lots of secondary hypertension. We have also consulted a large number of data and documents, gained our own clinical experience and understanding, based on the above, we write this booksecondary hypertension. It focuses on renal parenchymal hypertension, renal vascular hypertension, hypertension caused by other renal diseases, endocrine hypertension, hypertension caused by neurogenic and psychiatric disorders, as well as cardiovascular diseases, obstructive sleep apnea syndrome, drug-induced and exogenous hypertension, secondary hypertension induced by connective tissue diseases, blood system diseases, pregnancy-induced hypertension, and nearly hundreds of diseases. Each disease is described from general level to details, especially the mechanism of hypertension, standardized diagnosis, and treatment process.