Prevalence And Prediction Of Secondary Hypertension In Young Male Military Personnel

Objective: Current guidelines suggest screening for secondary causes in the early onset of hypertension (HTN) before 30 years. However, there have been few studies on secondary HTN in young adults. We aimed to investigate the prevalence and predictors of secondary HTN in young male military personnel. Design and method: This study used data from the Defense Medical Information System (DEMIS) database between January 2011 and June 2017. Of 6373 hypertensive males (19–29 years) from 19 military hospitals in South Korea, we comprehensively reviewed the medical records of 638 cases with any diagnosis associated with secondary HTN. Results: Secondary HTN was confirmed only in 140 subjects (2.2%) as a final diagnosis through detailed chart review. The most common causes were polycystic kidney disease (0.74%) and renal parenchymal diseases (0.38%). Other endocrinologic causes were very rare. The independent predictors for secondary HTN were abnormal thyroid function test (odds ratio [OR], 9.50; 95% confidence interval [CI], 4.84 to 19.45; P < 0.001), proteinuria (> trace) (OR, 6.13; 95% CI, 2.97 to 12.99, P < 0.001), hematuria (> trace) (OR, 4.37; 95% CI, 2.15 to 9.01; P < 0.001), severe HTN (>180/110 mmHg) (OR, 3.07; 95% CI, 1.42 to 6.65; P = 0.004), and overweight (body mass index > 23 kg/m2) (OR, 0.33; 95% CI, 0.19 to 0.59; P < 0.001). However, there were no significant differences in the family history of HTN, headache, total cholesterol level and diabetic state between primary and secondary HTN. Conclusions: Secondary HTN is very rare in young male military personnel. To ensure cost-effectiveness, screening for secondary HTN should be performed selectively considering various predictive factors.