In the endocrinology and metabolism diseases polyclinic of KTÜ Faculty of Medicine between 2010 -2023 determination of the frequency and etiology of endocrine hypertension in followed up hypertensive young adult patients

ABSTRACT Purpose: The aim of this study was to retrospectively determine the frequency and etiology of endocrine hypertension in young adult hypertensive patients and to compare patients with endocrine causes to those with essential hypertension. Materials and Methods: Between 2010 and 2023, a total of 137 patients aged between 18 and 40, followed up at the Endocrinology and Metabolism Diseases Outpatient Clinic of the Faculty of Medicine, Karadeniz Technical University, were included in the study. Patients under 18 years of age and over 40 years of age at the time of diagnosis of hypertension were excluded from the study. At the time of admission, data on age, gender, age at diagnosis, presenting symptoms, anti-hypertensive medications used, body mass index, echocardiographic findings, ambulatory blood pressure monitoring values, complete blood count parameters, renal function tests, electrolyte values, uric acid, CRP, glucose, ALT, LDL-cholesterol, triglyceride, HDL-cholesterol values, abdominal ultrasound, renal Doppler ultrasound, abdominal CT, MRI results, and pathology results of those who underwent surgery were recorded. Statistical analyses were performed using SPSS 26.0 software package. Mann-Whitney and chi-square tests were conducted for statistical analysis. Descriptive analyses of evaluation results were presented as number (n) and percentage (%) for categorical variables, and mean (M), standard deviation (SD), median (MD), minimum (Min), and maximum (Max) for numerical variables. The normal distribution of the data was assessed using kurtosis and skewness values (±1.5). A significance level of p < 0.05 was considered for all analyses. Results: The mean age of all patients was 30.04±6.94 years, with a mean age at diagnosis of 28.38±6.65 years and a mean BMI of 28.43±4.95. Of the cases evaluated in the study, 59 (43.1%) were male and 78 (56.9%) were female. Among the cases evaluated in the study, 31 (22.6%) were found to have an endocrine cause. Of the patients with endocrine causes, 8 (25.8%) were male and 23 (74.2%) were female. Among the patients with endocrine hypertension, 12 (38.7%) had primary hyperaldosteronism, 6 (19.4%) had hyperthyroidism, 5 (16.1%) had hypothyroidism, 4 (12.9%) had Cushing's syndrome, 3 (9.7%) had pheochromocytoma, and 1 (3.2%) had acromegaly. Conclusion: Endocrine hypertension was detected in 31 out of the 137 patients included in the study (22.6%). Among them, 12 (8.8%) had primary hyperaldosteronism, 4 (2.9%) had Cushing's syndrome, 3 (2.2%) had pheochromocytoma, 6 (4.4%) had hyperthyroidism, 5 (3.6%) had hypothyroidism, and 1 (0.7%) had acromegaly. It has been concluded that screening tests for primary hyperaldosteronism should be performed in patients diagnosed with hypertension under the age of 40. Keywords: Hypertension, Endocrine hypertension, Primary hyperaldosteronism, Pheochromocytoma, Cushing's syndrom