Patients with hypertension need to be alert for pheochromocytoma/paraganglioma

  Pheochromocytoma/paraganglioma (PHEO/PGL) accounts for 0.1% to 0.6% of patients with hypertension, with an annual incidence of 3 to 4 / 1 million people and an autopsy detection rate of about 0.09% to 0.25%. About 50-75% of PHEO/PGL is undiagnosed in the population. Currently, about 25% of PHEO is found incidentally on imaging, accounting for 4%-5% of incidental adrenal tumors. PGL accounts for 15% to 24% of all pheochromocytic tumors.  According to the Ministry of Health notification in October 2012, the prevalence of hypertension in China increased from 5.9% in 1959 to 18.8% in 2002, and it is estimated that there are 200 million hypertensive patients in China. It is estimated that there should be about 200,000 or even more patients with pheochromocytoma/paraganglioma, but according to domestic reports the number of patients with pheochromocytoma/paraganglioma found so far is far below 200,000, and there are still a large number of pheochromocytoma/paraganglioma undiagnosed in China because of the lack of awareness of pheochromocytoma/paraganglioma.  According to the current malignant pheochromocytoma/paraganglioma in our hospital, about 90% are accompanied by hypertension, and most of them are treated as primary hypertension for a long time before diagnosis, and only found to be pheochromocytoma/paraganglioma after physical examination or further examination.  Therefore, hypertensive patients should be alert to the possibility of pheochromocytoma/paraganglioma, especially those with juvenile hypertension, refractory hypertension, sudden hypertension, episodic hypertension (sudden high and low blood pressure), hypertension with headache, profuse sweating, palpitations, pale skin, emaciation, elevated blood sugar, constipation, etc. Pheochromocytoma/paraganglioma should be excluded. Currently, all hypertensive patients abroad are screened for pheochromocytoma/paraganglioma because most pheochromocytomas/paragangliomas are still benign lesions that, after surgical treatment, do not require long-term hypertensive medications and can reduce cardiovascular events (heart attack, brain attack, heart failure, kidney failure, etc.).