Hypertension — Essential and Secondary

A 38-year-old woman presents with hypertension (BP 158/96 mmHg), hypokalemia (K⁺ 3.1 mEq/L), and metabolic alkalosis (pH 7.48, HCO₃⁻ 32 mEq/L). Which single finding best discriminates primary hyperaldosteronism from essential hypertension?

A 52-year-old man with a 10-year history of essential hypertension presents for routine follow-up. His BP is 148/92 mmHg on current therapy with amlodipine 5 mg daily. Investigations show normal renal function, normal serum potassium, and normal plasma renin activity. Which of the following is NOT a recognized mechanism of essential hypertension?

A 52-year-old man from Delhi presents with hypertension detected on routine screening. His BP is 148/92 mmHg on two separate occasions. He has no symptoms, normal renal function, and normal serum electrolytes. What is the most common cause of hypertension in this patient?

Among patients with secondary hypertension, what is the most common identifiable cause?

A 48-year-old woman is diagnosed with stage 2 hypertension (BP 160/100 mmHg). Her workup for secondary causes includes serum electrolytes (normal), renal function (eGFR 92 mL/min/1.73m²), 24-hour urine metanephrines (normal), renal artery duplex ultrasound (normal), and thyroid function tests (normal). She is started on antihypertensive therapy. Which of the following investigations is NOT routinely indicated in the initial evaluation of all newly diagnosed hypertensive patients?