{"id":1726814,"date":"2022-04-10T20:41:45","date_gmt":"2022-04-11T00:41:45","guid":{"rendered":"https:\/\/myendoconsult.com\/learn\/?p=1726814"},"modified":"2023-03-16T05:35:46","modified_gmt":"2023-03-16T10:35:46","slug":"secondary-hypertension-mnemonic","status":"publish","type":"post","link":"https:\/\/myendoconsult.com\/learn\/secondary-hypertension-mnemonic\/","title":{"rendered":"Secondary hypertension mnemonic"},"content":{"rendered":"<p>A simple mnemonic for recalling the causes of secondary hypertension is <strong>CHARPLES<\/strong>. It is worth noting that most of the secondary causes of hypertension are of endocrine origin. Perturbations in each endocrine gland can contribute to secondary hypertension.<\/p>\n<h2>Causes of secondary hypertension<\/h2>\n<ul>\n<li><strong>C<\/strong> : <strong>C<\/strong>onn\u2019s syndrome (primary hyperaldosteronism), <a href=\"https:\/\/myendoconsult.com\/learn\/cushing-syndrome-mnemonic\/\"><strong>C<\/strong>ushing\u2019s syndrome<\/a>, <strong>C<\/strong>ongenital Adrenal Hyperplasia.<\/li>\n<li><strong>H <\/strong>: <strong>H<\/strong>yperparathyroidism, <strong>H<\/strong>yperthyroidism<\/li>\n<li><strong>A <\/strong>: <strong>A<\/strong>ortic coarctation, <strong>A<\/strong>drenal carcinoma<\/li>\n<li><strong>R <\/strong>: <strong>R<\/strong>enovascular hypertension, <strong>R<\/strong>eninoma, <strong>R<\/strong>enal parenchymal disease<\/li>\n<li><strong>P<\/strong> : <strong>P<\/strong>heochromocytoma<\/li>\n<li><strong>L<\/strong> : <strong>L<\/strong>iddle\u2019s syndrome, <strong>L<\/strong>icorice<\/li>\n<li><strong>E<\/strong> : <strong>E<\/strong>strogen pills (oral contraceptive pill)<\/li>\n<li><strong>S<\/strong> : <strong>S<\/strong>leep Apnea<\/li>\n<\/ul>\n<p><a href=\"https:\/\/myendoconsult.com\/learn\/wp-content\/uploads\/secondary-hypertension-mnemonic.jpg\" data-elementor-open-lightbox=\"yes\" data-elementor-lightbox-slideshow=\"1cd17bd\" data-elementor-lightbox-title=\"secondary hypertension mnemonic\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/myendoconsult.com\/learn\/wp-content\/uploads\/secondary-hypertension-mnemonic.jpg\" sizes=\"auto, (max-width: 640px) 100vw, 640px\" srcset=\"https:\/\/myendoconsult.com\/learn\/wp-content\/uploads\/secondary-hypertension-mnemonic.jpg 783w, https:\/\/myendoconsult.com\/learn\/wp-content\/uploads\/secondary-hypertension-mnemonic-289x300.jpg 289w, https:\/\/myendoconsult.com\/learn\/wp-content\/uploads\/secondary-hypertension-mnemonic-768x798.jpg 768w, https:\/\/myendoconsult.com\/learn\/wp-content\/uploads\/secondary-hypertension-mnemonic-624x649.jpg 624w\" alt=\"\" width=\"640\" height=\"665\" aria-describedby=\"gallery-1-1726994\" \/><\/a>Secondary hypertension mnemonic<\/p>\n<h2>The mechanism of secondary hypertension<\/h2>\n<p><strong>What is pseudohyperaldosteronism?<\/strong><\/p>\n<p>These are endocrine conditions that present with some of the clinical features of primary hyperaldosteronism (hypertension and hypokalemia) but do not exhibit the expected increase in plasma <a href=\"https:\/\/myendoconsult.com\/learn\/aldosterone-renin-ratio\/\">aldosterone to plasma renin ratio<\/a>. Patients with pseudohyperaldosteronism have low levels of both <a href=\"https:\/\/myendoconsult.com\/learn\/aldosterone-renin-ratio\/\">aldosterone and renin<\/a>.<\/p>\n\n<table id=\"tablepress-52\" class=\"tablepress tablepress-id-52\">\n<tbody>\n<tr class=\"row-1\">\n\t<td class=\"column-1\">Condition<\/td><td class=\"column-2\">Mechanism<\/td>\n<\/tr>\n<tr class=\"row-2\">\n\t<td class=\"column-1\">Liddle\u2019s syndrome<\/td><td class=\"column-2\">A gain-of-function mutation of the gene encoding the amiloride-sensitive epithelial sodium chloride transporter<\/td>\n<\/tr>\n<tr class=\"row-3\">\n\t<td class=\"column-1\">Gordon syndrome (Familial hyperkalemic hypertension)<\/td><td class=\"column-2\">A gain of function mutation of the thiazide-sensitive sodium-chloride co-transporter in the distal nephron. Unlike other causes of pseudohyperaldosteronism, Gordon Syndrome is associated with hyperkalemia instead of hypokalemia.<\/td>\n<\/tr>\n<tr class=\"row-4\">\n\t<td class=\"column-1\">Defects in adrenal steroidogenesis <\/td><td class=\"column-2\">Deficiency of 11beta-hydroxylase enzyme results in a build-up of 11-Deoxycorticosterone (which has intrinsic mineralocorticoid activity) <\/td>\n<\/tr>\n<tr class=\"row-5\">\n\t<td class=\"column-1\">Cushing\u2019s syndrome<\/td><td class=\"column-2\">Excess cortisol binds to the mineralocorticoid receptor due to saturation of the 11beta-hydroxysteroid dehydrogenase 2 enzyme. See <a href=\"https:\/\/myendoconsult.com\/learn\/cortisol-cortisone-shunt\/\">cortisol to cortisone shunt<\/a><\/td>\n<\/tr>\n<tr class=\"row-6\">\n\t<td class=\"column-1\">Congenital Apparent mineralocorticoid excess<\/td><td class=\"column-2\">An autosomal recessive condition characterized by an inactivating mutation of the 11beta-hydroxysteroid dehydrogenase 2 enzyme <\/td>\n<\/tr>\n<tr class=\"row-7\">\n\t<td class=\"column-1\">Excessive intake of licorice, grapefruits or carbenoxolone. Medication induced apparent mineralocorticoid excess<\/td><td class=\"column-2\">Inhibition of 11beta-hydroxysteroid dehydrogenase 2. Glycyrrhizic acid inhibits 11beta-hydroxysteroid dehydrogenase 2 enzyme. Glycyrrhizic acid is present in the root of the licorice plant (Glycyrrhiza glabra).<\/td>\n<\/tr>\n<tr class=\"row-8\">\n\t<td class=\"column-1\">Medication-induced<\/td><td class=\"column-2\">Corticosteroids and contraceptives<\/td>\n<\/tr>\n<tr class=\"row-9\">\n\t<td class=\"column-1\">Congenital Adrenal Hyperplasia<\/td><td class=\"column-2\">11beta-hydroxylase and 17alpha-hydroxylase deficiency leads to a buildup of 11-Deoxycorticosterone (intrinsic mineralocorticoid activity)<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<!-- #tablepress-52 from cache -->\n<h2>References<\/h2>\n<p>Armanini D, Cal\u00f2 L, Semplicini A. Pseudohyperaldosteronism: pathogenetic mechanisms. <a href=\"https:\/\/doi.org\/10.1080\/713609355\">Crit Rev Clin Lab Sci. 2003 Jun;40(3):295-335.<\/a><\/p>\n<h2>Images(s) Courtesy<\/h2>\n<p>MyEndoConsult<\/p>\n","protected":false},"excerpt":{"rendered":"<p>A simple mnemonic for recalling the causes of secondary hypertension is CHARPLES. It is worth noting that most of the secondary causes of hypertension&hellip;<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[107],"tags":[],"class_list":["post-1726814","post","type-post","status-publish","format-standard","hentry","category-mnemonics"],"_links":{"self":[{"href":"https:\/\/myendoconsult.com\/learn\/wp-json\/wp\/v2\/posts\/1726814","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/myendoconsult.com\/learn\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/myendoconsult.com\/learn\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/myendoconsult.com\/learn\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/myendoconsult.com\/learn\/wp-json\/wp\/v2\/comments?post=1726814"}],"version-history":[{"count":53,"href":"https:\/\/myendoconsult.com\/learn\/wp-json\/wp\/v2\/posts\/1726814\/revisions"}],"predecessor-version":[{"id":4415831,"href":"https:\/\/myendoconsult.com\/learn\/wp-json\/wp\/v2\/posts\/1726814\/revisions\/4415831"}],"wp:attachment":[{"href":"https:\/\/myendoconsult.com\/learn\/wp-json\/wp\/v2\/media?parent=1726814"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/myendoconsult.com\/learn\/wp-json\/wp\/v2\/categories?post=1726814"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/myendoconsult.com\/learn\/wp-json\/wp\/v2\/tags?post=1726814"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}