Surgical hypertension

Abstract

Hypertension is an extremely morbid condition affecting tens of millions of individuals in the United States. The vast majority (95%) of patients have primary, or idiopathic, hypertension. Treatment of these patients is an ongoing process that requires close follow-up and frequent adjustments in medications and risk-factor management. A very small percentage of individuals afflicted with hypertension may be amenable to a surgical cure. This chapter outlined surgical causes of hypertension and their presentation, workup, and treatment. The underlying tenet in the diagnosis and treatment of surgical hypertension includes a complete history, a complete physical exam, and a high index of suspicion on the part of the clinician. After clinical presentation and suspicion suggest a particular etiology, the clinician has a variety of biochemical and radiologic studies to help confirm or rule out the diagnosis. These tests are not indicated in all patients with hypertension. Rather, they should be used selectively, when a reasonable chance of identifying a surgical etiology exists. © Springer Science+Business Media, Inc. 2005.