RATIONAL TESTING Investigating hypertension in younger patients

center dot Secondary hypertension may account for up to 30% of diagnoses of young onset hypertension center dot Thyroid dysfunction, renal parenchymal disease, and renal artery stenosis secondary to fibromuscular dysplasia are the most common causes of secondary hypertension in younger patients center dot Testing for 24 hour urinary metanephrines should be carried out only if the patient has phaeochromocytoma symptoms, clinical signs, or center dot Random (spot) serum cortisol tests are usually uninformative. Consider late evening salivary cortisol center dot If treating patients with young onset hypertension empirically, revisit a diagnosis of secondary hypertension following post-treatment blood tests, or if blood pressure control is not achieved or