ABSTRACT
Evaluation for the major identifiable (or secondary) causes of hypertension is outlined in Table 8. Usually the initial workup for these often reversible causes is limited to patients with features of ‘inappropriate’ hypertension (Table 9). The one most likely to be found in the elderly is atherosclerotic renovascular disease, particularly when hypertension appears or worsens suddenly and develops on the background of extensive atherosclerotic disease elsewhere. If the initial screening studies are positive or clinical suspicion is strong, the additional studies should be obtained even if initial studies are negative (Vasbinder et al., 2001). The recognition of renal vascular disease is particularly important, as appropriate medical therapy may control hypertension and prevent progressive renal damage (van Jaarsveld et al., 2000).
