Zusammenfassung
Von herausragender Bedeutung in der Hochdruckdiagnostik ist der Ausschluss sekundärer, insbesondere endokriner Ursachen. Hierbei stehen Erkrankungen der Nebenniere im Vordergrund, sehr selten wird über die Hochdruckmanifestation eine Erkrankung beispielsweise der Schilddrüse oder Nebenschilddrüsen oder eine Akromegalie diagnostiziert. Unter den adrenalen Hochdruckformen sind die häufigsten die Mineralokortikoid-Hypertonie (und hier in erster Linie der primäre Hyperaldosteronismus), der Hypercortisolismus unterschiedlichster Genese und das Phäochromozytom. Aufgrund der neuen Häufigkeitsdaten, insbesondere für den primären Hyperaldosteronismus, wird die Prävalenz endokriner Hochdruckursachen in der hypertensiven Population auf annähernd 8 % geschätzt. Dies verdeutlicht zum einen ein nahezu epidemisches Ausmaß dieses Problems und zum anderen zeigt es, dass eine rationelle Früherkennung und Diagnostik notwendig ist.
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Prof. Dr. med. Hendrik Lehnert
Chair of Medicine, Warwick Medical School, Coventry University Hospital
Clinical Sciences Building
Clifford Bridge Road Coventry CV2
Email: h.lehnert@warwick.ac.uk
