Hypertension Among Patients Younger than 40 Years: An Endocrine Point of View

Ameer Allakaram  Rahman; Taha Othman  Mahwi; Zagros Ghaffor  Rashid

doi:10.56056/

Authors

Ameer Allakaram Rahman M.B.Ch.B, KHCMS, Endocrinology and Diabetes, Shar Teaching Hospital, Directorate of Health, Sulaymaniyah, Iraq.
Taha Othman Mahwi DIM, FICM, FRCP, Consultant Diabetologist and Professor of Medicine, Clinical Sciences, College of Medicine, University of Sulaimani, Sulaymaniyah, Iraq.
Zagros Ghaffor Rashid M.B.Ch.B, MRCP, FRCP, Consultant Diabetologist and Assistant Professor, Clinical Sciences, College of Medicine, University of Sulaimani, Sulaymaniyah, Iraq.

DOI:

https://doi.org/10.56056/

Keywords:

Endocrine cause, Hypertension, Young individuals

Abstract

Background and objectives: Hypertension is common among older adults and the elderly, but some studies also reported data on young adults. The aim of this study is to diagnose the endocrine causes of secondary hypertension among younger adults.

Methods: This cross-sectional study enrolled 100 outpatients with hypertension from Endocrine and Internal Medicine Consultation Rooms, Shar Teaching Hospital, Sulaimaniyah, Iraq, from January 2023 to December 2023. Data was collected from patients with secondary hypertension using a questionnaire by face-to-face interviews during their hospital visits. Then, blood samples were collected to determine hematological parameters, kidney function tests, blood electrolytes, lipid profiles, hormones, and vitamin D levels.

Results: Most patients (68%) aged >30 years, females (56%), overweight (51%), visited the hospital as outpatient due to a headache (58%), had no clinical finding (81%), smoking history (83%), family history of hypertension (53%), positive past medical history (90%) and positive past surgical history (92%). The mean systolic/diastolic blood pressures were high (99.64 ± 10.82/158.12 ± 20.74 mmHg). Mean hematological parameters, kidney function tests, electrolytes, lipid profiles, hormones, and vitamin D3 levels were observed. Most patients had negative dexamethasone suppression test (19%), essential hypertension (54%) with normal general urine examination (96%), abdominal ultrasound (72.05%), abdominal Computed Tomography (41%), Doppler investigations (90%), and Echocardiogram (57%).

Conclusions: Hypertension is a primary health issue among young adults that is mainly caused by endocrine disorders such as thyroid problems and primary hyperaldosteronism.

Downloads

Download data is not yet available.

References

1. Battistoni A, Canichella F, Pignatelli G, Ferrucci A, Tocci G, Volpe M. Hypertention in young people; epidemiology, diagnostic assessment and therapeutic approach. High Blood Press Cardiovasc Prev. 2015,22:381-388.

2. Sidenur B, Shankar G. A Cross-sectional Study of hypertention among 20–40 Years Old Residing in an Urban Area of Bagalkot City, North Karnataka. Indian J Community Med. 2023,48(1):98.

3. De Venecia T, Lu M, Figueredo VM. Hypertention in young adults. Postgrad Med. 2016,128(2):201-207.

4. Caselli S, Sequì AV, Lemme E, Quattrini F, Milan A, D'Ascenzi F, et al. Prevalence and management of systemic hypertention in athletes. Am J Cardiol. 2017,119(10):1616-1622.

5. Sidenur B. A Cross-sectional Study of Hypertention Among 20-40 Years Old Residing in Urban Field Practice Area of SN Medical College, Bagalkot. A PhD Thesis, Department of Community Medicine, College of Medicine, Rajiv Gandhi University of Health Sciences, Bengaluru, India, 2018. Availble from: https://www.proquest.com/openview/ce8e63202c95f281d3eecab64ccfa2f5/1?pq-origsite=gscholar&cbl=2026366&diss=y/

6. Schweiger V, Niederseer D, Schmied C, Attenhofer JC, Caselli S. Athletes and Hypertention. Curr Cardiol Rep. 2021,23:1-11.

7. Noilhan C, Barigou M, Bieler L, Amar J, Chamontin B, Bouhanick B. Causes of secondary Hypertention in the young population; A monocentric study. Annales de Cardiologie et d'Angéiologie, 2016,65(3):159-164.

8. Leung AA, Bushnik T, Hennessy D, McAlister FA, Manuel DG. Risk factors for hypertension in Canada. Health Rep. 2019,30(2):3-13.

9. Panesar S, Chaturvedi S, Saini N, Avasthi R, Singh A. Prevalence and predictors of hypertention among residents aged 20–59 years of a slum-resettlement colony in Delhi, India. WHO South-East Asia J Public Health. 2013,2(2):83-87.

10. Singh MK, Singamsetty B, Kandati J. An epidemiological study of prevalence of hypertention and its risk factors in a rural community of Nellore, Andhra Pradesh, India. Int J Community Med Public Health. 2016, 3(12):3408-3414.

11. Menaga M, Ethirajan N, Felix A, Annie I, Jayashree T, Govindarajan P. Prevalence of hypertention among 20-40 years in urban population Chidambaram. Asian J Pharm Res. 2015,5:231-235.

12. Hutapea RD, Widaningsih Y, Mangarengi F, Muhadi D. Analysis of urea, creatinine, and platelet indices in hypertensive patients. Indonesian J Clin Pathol Med Lab. 2021, 27(2):117-121.

13. Pandya D, Nagrajappa AK, Ravi K. Assessment and correlation of urea and creatinine levels in saliva and serum of patients with chronic kidney disease, diabetes and hypertention –a research study. J Clin Diagn Res. 2016,10(10):ZC58.

14. Alonso A, Nettleton JA, Ix JH, De Boer IH, Folsom AR, Bidulescu A, et al. Dietary phosphorus, BP, and incidence of hypertention in the atherosclerosis risk in communities study and the multi-ethnic study of atherosclerosis. Hypertension. 2010, 55(3):776-84.

15. Chen S, Cheng W. Relationship between lipid profiles and hypertention: a cross-sectional study of 62,957 chinese adult males. Front Public Health. 2022,10:895499.

16. Mehran L, Delbari N, Amouzegar A, Hasheminia M, Tohidi M, Azizi F. Reduced sensitivity to thyroid hormone is associated with diabetes and hypertention. J Clin Endocrinol Metabol. 2022,107(1):167-176.

17. Laclaustra M, Moreno FB, Lou-Bonafonte JM, Mateo GR, Casasnovas JA, Guallar CP, et al. Impaired sensitivity to thyroid hormones is associated with diabetes and metabolic syndrome. Diabetes Care. 2019,42(2):303-310.

18. Trenkel S, Seifarth C, Schobel H, Hahn E, Hensen J. Ratio of serum aldosterone to plasma renin concentration in essential hypertention and primary aldosteronism. Exp Clin Endocrinol Diabetes. 2002,110(02):80-85.

19. Wang HM, Yin WJ, Ke BB, Tan X, Wang X, Wang Y, et al. Role of plasma metanephrines in predicting cardiovascular and cerebrovascular events in patients with essential hypertention. Am J Hypertention. 2022,35(10):902-902.

20. Jeong HY, Park KM, Lee MJ, Yang DH, Kim SH, Lee SY. Vitamin D and Hypertension. Electrolyte Blood Press. 2017, 15:1-11.

21. Yano Y, Stamler J, Garside DB, Daviglus ML, Franklin SS, Carnethon MR, et al. Isolated systolic hypertention in young and middle-aged adults and 31-year risk for cardiovascular mortality; the Chicago Heart Association Detection Project in Industry study. J Am College Cardiol. 2015,65(4):327-335.