Medscape InDiscussion: Secondary Hypertension

Drs Marwah Abdalla and Susan Redline discuss when to suspect sleep apnea; how to approach screening, diagnosis, and treatment; and how it fits into hypertension management. Relevant disclosures can be found with the episode show notes on Medscape https://www.medscape.com/viewarticle/1003187. The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals. Resources Secondary Hypertension: Evaluation and Management https://pubmed.ncbi.nlm.nih.gov/37115960/ Obstructive Sleep Apnea-Related Hypertension: A Review of the Literature and Clinical Management Strategy https://pubmed.ncbi.nlm.nih.gov/39210083/ Racial/Ethnic Differences in Sleep Disturbances: The Multi-Ethnic Study of Atherosclerosis (MESA) https://pubmed.ncbi.nlm.nih.gov/25409106/ Sleep-Disordered Breathing in Hispanic/Latino Individuals of Diverse Backgrounds. The Hispanic Community Health Study/Study of Latinos https://pubmed.ncbi.nlm.nih.gov/24392863/ Comorbid Insomnia and Sleep Apnea: From Research to Clinical Practice https://pubmed.ncbi.nlm.nih.gov/40258387/ Performance of Four Screening Tools for Identifying Obstructive Sleep Apnea Among Patients With Insomnia https://pubmed.ncbi.nlm.nih.gov/40060365/ Life's Essential 8: Updating and Enhancing the American Heart Association's Construct of Cardiovascular Health: A Presidential Advisory From the American Heart Association https://pubmed.ncbi.nlm.nih.gov/35766027/ Respiratory Event Index Underestimates Severity of Sleep Apnea Compared to Apnea-Hypopnea Index https://pubmed.ncbi.nlm.nih.gov/38264141/ Clinical Study of Two Mandibular Advancement Devices in the Treatment of Obstructive Sleep Apnea: A Pilot Randomized Controlled Trial https://pubmed.ncbi.nlm.nih.gov/39696299/ Hypoglossal Nerve Stimulation for Obstructive Sleep Apnea in Adults: An Updated Systematic Review and Meta-Analysis https://pubmed.ncbi.nlm.nih.gov/39401661/ Obstructive Sleep Apnea Endophenotypes https://pubmed.ncbi.nlm.nih.gov/40292204/ Detection of Sleep Apnea Using Wearable AI: Systematic Review and Meta-Analysis https://pubmed.ncbi.nlm.nih.gov/39255014/ Technologies for Sleep Monitoring at Home: Wearables and Nearables https://pubmed.ncbi.nlm.nih.gov/37519880/

Drs Marwah Abdalla and Vivek Bhalla discuss the screening, management, and future of primary aldosteronism — a common cause of secondary hypertension. Relevant disclosures can be found with the episode show notes on Medscape https://www.medscape.com/viewarticle/1003186. The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals. Resources Secondary Hypertension https://www.ncbi.nlm.nih.gov/books/NBK544305/ Primary Aldosteronism https://emedicine.medscape.com/article/127080-overview The Unrecognized Prevalence of Primary Aldosteronism: A Cross-Sectional Study https://pubmed.ncbi.nlm.nih.gov/32449886/ 2025 AHA/ACC/AANP/AAPA/ABC/ACCP/ACPM/AGS/AMA/ASPC/NMA/PCNA/SGIM Guideline for the Prevention, Detection, Evaluation and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines https://pubmed.ncbi.nlm.nih.gov/40811516/ Expanding the Search for Primary Aldosteronism in Clinical Settings https://pubmed.ncbi.nlm.nih.gov/40811492/ Primary Hyperaldosteronism in Hypertension https://www.escardio.org/Councils/Council-for-Cardiology-Practice-(CCP)/Cardiopractice/primary-hyperaldosteronism-in-hypertension Primary Aldosteronism: An Endocrine Society Clinical Practice Guideline https://pubmed.ncbi.nlm.nih.gov/40658480/ Primary Aldosteronism and the Role of Mineralocorticoid Receptor Antagonists for the Heart and Kidneys https://pubmed.ncbi.nlm.nih.gov/36375469/ The Effect of Spironolactone on Morbidity and Mortality in Patients With Severe Heart Failure. Randomized Aldactone Evaluation Study Investigators https://pubmed.ncbi.nlm.nih.gov/10471456/ Cardiometabolic Outcomes and Mortality in Medically Treated Primary Aldosteronism: A Retrospective Cohort Study https://pubmed.ncbi.nlm.nih.gov/29129576/ Aldosterone Synthase Inhibitors for Cardiorenal Protection: Ready for Prime Time? https://pubmed.ncbi.nlm.nih.gov/39557029/

Drs Marwah Abdalla and Lewis Blevins discuss Cushing Syndrome: Why it is frequently missed, how clinicians can screen for it, and how to manage it. Relevant disclosures can be found with the episode show notes on Medscape https://www.medscape.com/viewarticle/1003185. The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals. Resources Endogenous Cushing Syndrome https://emedicine.medscape.com/article/2233083-overview 2025 AHA/ACC/AANP/AAPA/ABC/ACCP/ACPM/AGS/AMA/ASPC/NMA/PCNA/SGIM Guideline for the Prevention, Detection, Evaluation and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines https://pubmed.ncbi.nlm.nih.gov/40811516/ Adrenal Hypercortisolism: A Closer Look at Screening, Diagnosis, and Important Considerations of Different Testing Modalities https://pubmed.ncbi.nlm.nih.gov/31069279/ Diagnostic Testing of Autonomous Cortisol Secretion in Adrenal Incidentalomas https://pubmed.ncbi.nlm.nih.gov/33032259/ Physiology, Renin Angiotensin System https://www.ncbi.nlm.nih.gov/books/NBK470410/ Dexamethasone Suppression Test https://www.ncbi.nlm.nih.gov/books/NBK542317/ A New Clinical Model to Estimate the Pre-Test Probability of Cushing's Syndrome: The Cushing Score https://pubmed.ncbi.nlm.nih.gov/34675882/ Late-night Salivary Cortisol and Cortisone Should Be the Initial Screening Test for Cushing's Syndrome https://pubmed.ncbi.nlm.nih.gov/35671282/ Mild Autonomous Cortisol Secretion: Pathophysiology, Comorbidities and Management Approaches https://pubmed.ncbi.nlm.nih.gov/38649778/ SUN-451 Adrenalectomy Improves Cardiovascular Risk Factors in Patients With Mild Autonomous Cortisol Secretion: Results of a RCT https://pmc.ncbi.nlm.nih.gov/articles/PMC12543531/ Pheochromocytoma https://emedicine.medscape.com/article/124059-overview Fleischner Society Guideline Recommendations for Incidentally Detected Pulmonary Nodules and the Probability of Lung Cancer https://pubmed.ncbi.nlm.nih.gov/36049538/ Approach to Patients With Pseudo-Cushing's States https://pubmed.ncbi.nlm.nih.gov/31846432/ Metabolic Syndrome https://www.ncbi.nlm.nih.gov/books/NBK459248/

Drs Marwah Abdalla and Sandra J. Taler discuss practical workups in a busy practice when you suspect Secondary Hypertension, including clues from history, exam, and labs. Relevant disclosures can be found with the episode show notes on Medscape https://www.medscape.com/viewarticle/1003184. The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals. Resources Secondary Hypertension https://www.ncbi.nlm.nih.gov/books/NBK544305/ Approach to the Diagnosis of Secondary Hypertension in Adults https://pubmed.ncbi.nlm.nih.gov/34728882/ Obstructive Sleep Apnea-Related Hypertension: A Review of the Literature and Clinical Management Strategy https://pubmed.ncbi.nlm.nih.gov/39210083/ Primary Aldosteronism https://emedicine.medscape.com/article/127080-overview Pheochromocytoma https://emedicine.medscape.com/article/124059-overview Herbal Products That May Contribute to Hypertension https://pubmed.ncbi.nlm.nih.gov/23271526/ The Effects of Nonsteroidal Anti-Inflammatory Drugs on Blood Pressure in Hypertensive Patients https://pubmed.ncbi.nlm.nih.gov/21646872/ Attention Deficit Hyperactivity Disorder (ADHD) https://emedicine.medscape.com/article/289350-overview Attention-Deficit/Hyperactivity Disorder Medications and Long-Term Risk of Cardiovascular Diseases https://pubmed.ncbi.nlm.nih.gov/37991787/ Mechanisms Underlying Vascular Endothelial Growth Factor Receptor Inhibition-Induced Hypertension: The HYPAZ Trial https://pubmed.ncbi.nlm.nih.gov/33775123/ Investigation of the Mechanism of Hypertension Caused by BTKi in the Treatment of Hematologic Diseases https://pubmed.ncbi.nlm.nih.gov/40453665/ Mallampati Score https://www.ncbi.nlm.nih.gov/books/NBK585119/ Multiple Endocrine Neoplasia Type 2 (MEN2) https://emedicine.medscape.com/article/123447-overview Evaluation and Management of Secondary Hypertension https://pubmed.ncbi.nlm.nih.gov/35227430/ Guidelines for the Management of Hypertension in CKD Patients: Where Do We Stand in 2024? https://pubmed.ncbi.nlm.nih.gov/39583143/ Flash Pulmonary Edema: Pickering Syndrome Due to Bilateral Renal Artery Stenosis https://pubmed.ncbi.nlm.nih.gov/35929077/