Apparent prevalence of curable hypertension in the Hypertension Detection and Follow-up Program

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Abstract
Data describing the 5485 participants in the stepped-care group of the Hypertension Detection and Follow-up Program were reviewed to determine the apparent prevalence of renal parenchymal and reversible, secondary hypertension. The investigation was limited and was not designed to identify all cases of secondary hypertension. Baseline prevalence of proteinuria was 3.6%, pyuria 71.%, hematuria 5.1% and elevated serum creatinine level (.gtoreq. 1.7 mg/dl) 2.7%. The combined occurrence of an elevated serum creatinine level plus one or more urinary abnormalities was noted in 0.95. Initial review of case reports revealed 6 participants with hypertension secondary to use of birth control pills and 3 participants with hypertension that was proved to be secondary to renovascular disease. Specific laboratory or historical criteria were used as indications to more intensive investigation in an additional 65 participants. Among these individuals, one participant with renovascualr disease and 3 with possible primary hyperaldosteronism were identified. A rapid-sequence i.v. urogram or radionuclide scan was performed on another subgroup of 62 participants whose hypertension was poorly controlled (diastolic BP, .gtoreq. 95 mm Hg). Of these 59 studies were negative, 1 was positive and 2 were equivocal. The frequency of clinically relevant cases of reversible, secondary hypertension, at least among individuals with mild to moderate elevation of blood pressure, is low.

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