People with hypertension with one or more of the following:
should be investigated for possible pheochromocytoma or paraganglioma screening.
Leung AA, Nerenberg K, Daskalopoulou SS, et al. Hypertension Canada’s 2016 Canadian Hypertension Education Program Guidelines for Blood Pressure Measurement, Diagnosis, Assessment of Risk, Prevention, and Treatment of Hypertension. Can J Cardiol. 2016; 32(5): 569-588. doi: 10.1016/j.cjca.2016.02.066.
The following patients should be considered for screening for pheochromocytoma or paraganglioma (Grade D):
i. Patients with paroxysmal, unexplained, labile, and/or severe (BP 180/110 mm Hg) sustained hypertension refractory to usual antihypertensive therapy;
ii. Patients with hypertension and multiple symptoms suggestive of catecholamine excess (eg, headaches, palpitations, sweating, panic attacks, and pallor);
iii. Patients with hypertension triggered by b-blockers, monoamine oxidase inhibitors, micturition, changes in abdominal pressure, surgery, or anaesthesia;
iv. Patients with an incidentally discovered adrenal mass;
v. Patients with a predisposition to hereditary causes (eg, multiple endocrine neoplasia 2A or 2B, von Recklinghausen neurofibromatosis type 1, or Von Hippel-Lindau disease)
Treatment of hyperaldosteronism and pheochromocytoma are outlined in Supplemental Tables S7 and S8, respectively.