NỒNG ĐỘ HORMONE VÀ TỶ LỆ U TUYẾN THƯỢNG THẬN TRÊN BỆNH NHÂN 18 ĐẾN 35 TUỔI CÓ CHẨN ĐOÁN TĂNG HUYẾT ÁP TẠI BỆNH VIỆN ĐẠI HỌC Y DƯỢC TP.HCM

Abstract

Background: Hypertension is a common medical condition in the Vietnamese and global populations, leading to various cardiovascular, renal, peripheral vascular complications, and mortality. Approximately 5-10% of hypertension cases have secondary causes related to renal and endocrine disorders, often occurring in individuals under 40 years old. The approach to young patients with hypertension involves using biochemical tests for screening, followed by diagnostic confirmation of the underlying causes through hormone assays and imaging techniques. Objectives: To determine the incidence of hypertension causes in the 18-35 age group and examine the concentrations of three adrenal hormones (aldosterone, metanephrine, normetanephrine) and renin levels in hypertensive patients aged 18-35 who were examined and treated at Ho Chi Minh City University Medical Center from January 2020 to December 2022. Additionally, the study aimed to determine the incidence of adrenal tumors in these patients based on pelvic CT scan results. Methods: A cross-sectional study was conducted, utilizing data from hypertensive patients aged 18-35 who were diagnosed and treated at Ho Chi Minh City University Medical Center from January 2020 to December 2022. Results: A total of 133 hypertensive patients were surveyed, with male patients comprising 3.5 times the number of female patients. The median age was 30, ranging from 18 to 35 years old. The median serum renin concentration before intervention was 24.1 (11.3-55.7) pg/ml; aldosterone was 10.83 (6.14-

19.34) ng/dl; metanephrine was 57.6 (33.1-93.79) pg/ml, and normetanephrine was 136.47 (85.8-202.4) pg/ml. Primary hypertension accounted for 30.1% of cases in the 18-35 age group, while 69.1% had secondary hypertension, including 26.3% with adrenal tumors. Nearly two-thirds of patients with adrenal tumors were male. Most patients had unilateral adrenal tumors, with only one patient having tumors in both adrenals. Conclusion: In this study, hypertension in individuals aged 18-35 was predominantly secondary hypertension, with a higher incidence in males. Among secondary hypertension cases, 26.3% were associated with adrenal tumors. The incidence of elevated renin levels was found in 39.1% of patients, while the percentages of patients with increased metanephrine and normetanephrine levels    were    27.1%    and    29.3%,    respectively.

Additionally, 12.0% of surveyed patients exhibited elevated aldosterone levels.