Renal Causes
- Chronic kidney disease (glomerulonephritis, polycystic kidney disease)
- Renal artery stenosis
- Renal parenchymal disease
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- Flank pain (renal artery stenosis)
- Oedema, haematuria (glomerulonephritis)
- Growth retardation, fatigue
- Headaches
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- Urinalysis (proteinuria, haematuria)
- Blood urea nitrogen (BUN) and creatinine levels
- Renal ultrasound
- Doppler ultrasound for renal artery stenosis
- CT or MRI for renal vascular abnormalities
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- Treat underlying renal condition (e.g., glomerulonephritis, polycystic kidney disease)
- ACE inhibitors or ARBs for hypertension control
- Surgical intervention for renal artery stenosis
- Dialysis in cases of end-stage renal disease
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Endocrine Causes
- Primary hyperaldosteronism (Conn’s syndrome)
- Phaeochromocytoma
- Cushing’s syndrome
- Congenital adrenal hyperplasia
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- Muscle weakness, fatigue (hyperaldosteronism)
- Palpitations, sweating, headaches (pheochromocytoma)
- Weight gain, moon face (Cushing’s syndrome)
- Ambiguous genitalia, salt-wasting crisis (congenital adrenal hyperplasia)
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- Plasma aldosterone and renin levels
- 24-hour urinary catecholamines (pheochromocytoma)
- Dexamethasone suppression test (Cushing’s)
- ACTH and cortisol levels
- Abdominal CT or MRI (adrenal tumours)
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- Resection of adrenal or pheochromocytoma tumours
- Spironolactone for hyperaldosteronism
- Glucocorticoid replacement for adrenal insufficiency
- Antihypertensives (beta blockers, ACE inhibitors)
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Cardiovascular Causes
- Coarctation of the aorta
- Congenital heart defects (e.g., aortic stenosis)
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- Hypertension in the upper extremities
- Weak or absent femoral pulses
- Headaches, chest pain
- Claudication (pain in the legs due to poor circulation)
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- Blood pressure measurement in all four limbs (higher in upper limbs)
- Echocardiogram
- Chest X-ray (rib notching, cardiomegaly)
- CT or MRI angiography for detailed vascular imaging
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- Surgical repair of coarctation of the aorta
- Balloon angioplasty or stenting for aortic narrowing
- Antihypertensives post-surgery (beta blockers or calcium channel blockers)
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Neurological Causes
- Increased intracranial pressure (e.g., due to brain tumour, trauma)
- Autonomic dysreflexia
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- Severe headaches
- Nausea, vomiting
- Visual disturbances
- Seizures
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- CT or MRI of the brain
- Fundoscopic examination (papilledema)
- CSF pressure measurement (lumbar puncture)
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- Treat underlying cause (e.g., tumour resection, reduce intracranial pressure)
- Antihypertensive therapy to manage hypertension
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Obesity-Related Hypertension
- Primary hypertension often associated with obesity
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- Elevated blood pressure
- Fatigue, decreased exercise tolerance
- Possible insulin resistance or diabetes
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- Blood pressure monitoring
- Fasting glucose, lipid profile
- Renal function tests
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- Lifestyle modification (diet, exercise)
- Weight reduction
- Pharmacological treatment if lifestyle changes are insufficient (ACE inhibitors, beta blockers)
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