Differential Diagnosis for Stage 1 Hypertension
Single Most Likely Diagnosis
- Essential Hypertension: This is the most common cause of stage 1 hypertension, accounting for about 90-95% of cases. It is a diagnosis of exclusion, made after ruling out secondary causes of hypertension. Essential hypertension is often associated with a family history, obesity, physical inactivity, and excessive alcohol consumption.
Other Likely Diagnoses
- Primary Aldosteronism: A condition characterized by the excessive production of aldosterone, leading to hypertension. It is more common in women and often presents with resistant hypertension.
- Chronic Kidney Disease (CKD): CKD can cause hypertension due to fluid overload, electrolyte imbalances, and activation of the renin-angiotensin-aldosterone system.
- Sleep Apnea: Obstructive sleep apnea is a common condition that can contribute to the development of hypertension, possibly due to intermittent hypoxia and increased sympathetic activity.
Do Not Miss Diagnoses
- Pheochromocytoma: A rare tumor of the adrenal gland that produces excess catecholamines, leading to episodic or sustained hypertension. Although rare, it is crucial to diagnose due to the potential for severe cardiovascular complications.
- Cushing's Syndrome: A condition caused by excess cortisol production, which can lead to hypertension, among other symptoms. Early diagnosis is essential to prevent long-term complications.
- Coarctation of the Aorta: A congenital condition characterized by narrowing of the aortic isthmus, leading to hypertension in the arms, with or without lower blood pressure in the legs.
Rare Diagnoses
- Hyperthyroidism: Excess thyroid hormone can cause hypertension, although it is a less common cause.
- Hyperparathyroidism: Elevated parathyroid hormone levels can lead to hypertension, possibly due to increased calcium levels and vascular stiffness.
- Renal Artery Stenosis: Narrowing of the renal arteries can cause hypertension due to activation of the renin-angiotensin-aldosterone system. It is more common in younger women and those with fibromuscular dysplasia.