Hyperreninic Arterial Hypertension — Difficulties in Differential Diagnosis. Clinical Observation

Secondary arterial hypertension (SAH) is characterised by the presence of a specific potentially treatable cause of hypertension, higher blood pressure (BP) values, often refractory to hypotensive therapy, and higher prevalence in young adults. Diagnosis of VtAH involves searching for causes according to the principle ‘from simple to complex’ at the outpatient and inpatient stages of examination. The article describes a clinical case of a 44-year-old woman without risk factors for AH, hospitalised for hypertensive crisis on the background of uncontrolled AH. Multistage laboratory and instrumental diagnostics was performed to exclude renal, endocrine, vascular pathology. High values of renin with normal values of other hormones of adrenal, pituitary, thyroid and parathyroid glands were the basis for searching for renal and extrarenal renin-producing tumours, which resulted in the diagnosis of hyperrenin essential AH. The article presents the classification of VtAH with a list of recommended diagnostic measures, principles of therapy of hyperreninic AH, which are of practical importance for the therapist, general practitioner, endocrinologist, nephrologist.