Clinically known as hypertension, high blood pressure can cause a host of problems if left untreated. This article discusses the common causes of secondary hypertension. Its prevalence tend to raise with age in most populations. An attempt to detect secondary causes of hypertension is important due to the potential for cure with appropriate treatment.
Arterial hypertension is a common and preventable cardiovascular risk factor, leading to about 1. Secondary hypertension is a type of hypertension with an underlying, potentially correctable cause. Clinicians often consider secondary causes such as renal. Although not causes themselves, risk factors such as being overweight can increase a persons chances of developing the condition. It may seem like there are many types of hypertension, but some are incorrectly classified. In adults, earlier studies identified renal parenchymal and vascular disease as the most common causes of secondary hypertension.
Basic concepts, types, pathogenetic factors hypertension. If that is the case, it is called secondary hypertension. When the causes are known such as preeclampsia, kidney disease, or certain medicines it is called secondary hypertension. Blood pressure, antihypertensive drug treatment and the risks of stroke and of coronary heart disease. Both can lead to severe, lifealtering, and possibly fatal. In about 10% of people, high blood pressure is caused by another disease. Drugs can cause secondary hypertension, including overthecounter medications such as ibuprofen motrin, advil, and others and pseudoephedrine afrin, sudafed, and others. Specialist investigations for possible secondary causes of hypertension.
Diagnosis and investigations of secondary hypertension. Doctors suspect a link between hypertension, or high blood pressure, and diabetes, and each condition can make the other worse. A secondary etiology may be suggested by symptoms e. With this type of hypertension, there is no single identifiable cause for high blood pressure. The prevalence, reversibility, and mortality of secondary hypertension among 3783 patients with moderately severe nonmalignant hypertension attending the glasgow scotland blood pressure clinic were assessed. Because of low prevalence, routine screening for secondary hypertension is not essential and cost effective. Hypertension remains one of the most significant causes of mortality worldwide. Blood pressure components, risk, and comorbidities of hypertension 10.
Also commonly known as essential hypertension, primary high blood pressure is a disorder which is associated with elevated blood pressure whose causes are not readily identifiable. In young adults with hypertension, only about 5% of hypertension is secondary hypertension. Estimating the pretest probability of a secondary identifiable cause of hypertension is problematic, because referral bias is a major problem in hypertension. Treatment of secondary forms of hypertension differs widely. The regional consultation on hypertension prevention and control held in abu dhabi, united arab emirates, 2022 december 2003, acknowledged the need for a standardized response to the growing challenge of hypertension. When secondary hypertension results from a tumor or a blood vessel abnormality, surgery may be recommended. Primary hypertension has no clear cause and is thought to be linked to genetics, poor diet, lack of exercise and obesity.
Secondary hypertension differs from the usual type of high blood pressure primary hypertension or essential hypertension, which is often referred to simply as high blood pressure. While an explanation might be possible, no underlying disease, condition, or disorder causes the high blood pressure to occur. A thorough medical history and physical examination can often give clues as to the presence of secondary causes of hypertension. In most cases hypertension will resolve, but some infants may require prolonged treatment. Although diagnostic standards are based on separate, officebased readings, both the nhlbi and european guidelines state that ambulatory bp monitoring abpm may be useful in confirming the diagnosis of hypertension, monitoring treatment, and evaluating for secondary causes. Secondary hypertension has an identifiable cause whereas primary hypertension has no known cause i. In fact, up to 85 % of children with hypertension have an identifiable cause. Most hypertension cannot be cured, only controlled. Diagnosis criteria the diagnosis of hypertension must be accompanied by an appropriate family. Renal disease constitutes the major group of secondary hypertension.
High blood pressure hypertension affects more than 70 million americans and, when left untreated, causes significant damage to the bodys organs. Most patients with hypertension have no clear etiology and are classified as having primary hypertension. Secondary hypertension secondary causes of hypertension tab. The list of secondary causes is well documented, and includes conditions that activate the reninangiotensinaldosterone system ras, ie. The treatment of secondary hypertension depends on its cause. Essential hypertension does not have an apparent cause. Secondary hypertension is clinically important because it may be reversible and hence, a search for the cause is warranted. High blood pressure, also known as hypertension, is classified as essential primary or secondary. It is the recommendation that all children with confirmed hypertension be evaluated for underlying causes to include renal parenchymal disease.
Failure to recognise secondary causes can lead to resistant hypertension, cardiovascular complications or complications of the underlying condition. Translated from english by this website translates english to other languages using an automated tool. Therapy of neonatal hypertension should be tailored to the severity of the blood pressure elevation, and to the underlying cause of hypertension as appropriate. Hypertension due to secondary causes is less likely to be seen in elderly individuals. This is the most common type of high blood pressure, occurring in up to 95% of patients. It is much less common than the other type, called essential hypertension, affecting only 5% of hypertensive patients. In general, druginduced pressure increases are small and transient. Whitecoat hypertension and labile hypertension are two such examples. Approach to a case of secondary hypertension sciencedirect. While the majority of patients have essential hypertension that does not have an identifiable cause, it is important to recognise secondary causes of hypertension. It has many different causes including endocrine diseases.
Some of the medical problems that can cause secondary hypertension. Secondary hypertension is a common cause of hypertension in adults, occurring in about 10% of hypertensive patients. Jan 01, 2003 a more aggressive evaluation for secondary causes of hypertension should be considered in certain clinical situations. Consider the need for specialist investigations in people with signs and symptoms suggesting a secondary cause of hypertension. A wide range of therapeutic agents are now available for management of neonatal hypertension in both the acute and chronic settings. Also commonly known as essential hypertension, primary high blood pressure is a disorder which is associated with elevated blood pressure whose causes.
Hypertension is the leading cause of strokes and heart attack. For some patients, antihypertensive medications may be a safer option than. Secondary hypertension accounts for approximately 510% of all cases of hypertension, with the remaining being primary hypertension. The most common forms of secondary hypertension are as follows. National high blood pressure education program partnership leader american institutes for research prospect center silver spring, md primary prevention of hypertension clinical and public health advisory from the national high blood pressure education program the working group. About 6% of the time, however, high blood pressure is caused by another condition or disease. The evaluation of a patient with hypertension depends upon the likely cause and the degree of difficulty in achieving acceptable blood pressure control since many forms of secondary hypertension cause treatmentresistant hypertension. It is preventable by medication and lifestyle modification. Hypertension, after diabetes mellitus, is the second leading cause of endstage renal disease esrd and together. Secondary hypertension or, less commonly, inessential hypertension is a type of hypertension which by definition is caused by an identifiable underlying primary cause. Patients likely to have essential idiopathic or primary hypertension. Recognition, diagnosis and treatment of secondary causes of hypertension lead to good. About 10% of patients with hypertension have a secondary. Currently this means that no specific cause is identified for the condition.
Learn vocabulary, terms, and more with flashcards, games, and other study tools. Secondary hypertension has a recognizable cause usually treatable or reversible, but these are rare causes. Diagnosis, epidemiology, and management of hypertension in. In particular, patients in whom hypertension develops at an early age, those who first exhibit hypertension when over age 50 years, or those previously well controlled who become refractory to treatment are more likely to have secondary hypertension. Secondary hypertension definition of secondary hypertension. Multiple risk factors for coronary heart disease in patients with hypertension. The deleterious effect of therapeutic agents is more pronounced in patients with preexisting hypertension, in those with renal failure, and in the elderly. Environmental factors such, as excess salt intake will raise someones blood pressure. When the causes of hypertension are unknown, this is called primary hypertension.
Prevalence the incidence and prevalence of hypertension depends upon the racial composition of population and criteria used to define hypertension see table 1. However, a small percentage of people with this type of high blood pressure may be able to get rid of it once. Patients likely to have essential idiopathic or primary hypertension undergo a relatively limited. Hypertension is the single biggest contributor to the global burden of disease, and is the most common chronic medical condition presenting to primary care physicians in singapore. Hypertension causes damage slowly over a long period of time without noticeable symptoms.
In such cases, when the root cause is treated, blood pressure. Covering primary hypertension definition, causes and risk factors, symptoms and secondary hypertension. When this happens, it is called secondary hypertension. Renal parenchymal disease is the most common cause. Secondary hypertension, issues in diagnosis and treatment. There are many known conditions that can cause secondary hypertension. Discovering the underlying cause most patients with hypertension have no clear etiology and are classified as having primary hypertension. Underlying causes of hypertension were found in 297 patients 7. Diagnosing secondary hypertension american family physician. Essential hypertension is poorly understood and may be due to a number causes including inheritance, kidney problems from hypoxia, drugs, nutritional deficiency, malnutrition, infection, genetic factors and neural activity. Essential hypertension or primary hypertension refers to high blood pressure in which the physician is unable to identify a specific cause. Fewer than 10% of patients have secondary hypertension. The clinical dx of coarctation of the aorta is based upon the characteristic findings of systolic hypertension in the upper extremities, diminished or delayed femoral pulses brachialfemoral delay, and low or unobtainable arterial blood pressure in the lower extremities.
In 5 to 10 % of patients a reversible cause for hypertension may be identified. The most common type of cardiovascular disease, high blood pressure causes our hearts to work harder by forcing blood to push against the walls of our arteries at an elevated level. Started in 1995, this collection now contains 6767 interlinked topic pages divided into a tree of 31 specialty books and 732 chapters. Hypertension, especially isolated systolic hypertension, is commonly found in older 6079 years of age and elderly. Secondary hypertension is attributable to an underlying medical disorder. Office blood pressure bp, outofoffice bp measurement with ambulatory bp monitoring, and selfbp measurement at home are reliable and important data for assessing hypertension. Early onset hypertension up to 85% of preadolescent children with hypertension have secondary cause most commonly renal parenchymal disease gn, congenital, reflux nephropathy may not present until adolescentyoung adult consider adding urine culture and renal ultrasonography as part of routine. In most of these cases renal dysfunction resulting from sever chronic kidney disease or renovascular disease is the most common secondary cause. According to a 2002 report from the who, cerebral vascular accident cva is the third cause of death on most developed countries. Jun 06, 2019 the treatment of secondary hypertension depends on its cause. Renovascular hypertension is caused by stenosis or obstruction of the renal artery and is observed in about 1% of hypertensive patients.
Among these, the major categories are renal parenchymal disease which includes chronic kidney disease and polycystic kidney. Especially in women, renal artery stenosis from fibromuscular dysplasia is the most common cause of secondary hypertension. Common causes of secondary hypertension include renal parenchymal disease, renovascular hypertension, conn syndrome and pheochromocytoma. Thats why its important to practice healthy habits, like regular exercise and eating a diet that. Preadolescent children with hypertension should be evaluated for possible secondary hypertension. Although most cases of hypertension are without an underlying cause i. Secondary hypertension, differential diagnosis time of care. Secondary hypertension is high blood pressure caused by another condition or disease. Secondary hypertension is more common than primary hypertension in infants and young children. Hypertension htn with no identifiable cause often develops gradually over years much of htn still falls in this category up to 85% in many reports. Secondary hypertension in a blood pressure clinic jama. Pheochromocytoma patients that have arterial hypertension may also present with hypertensive retinopathy, caused by retinal vasoconstriction, increased vascular permeability, and secondary.
Primary hypertension, also known as essential hypertension, is the most common type of hypertension. Most people with hypertension have essential hypertension. The regional consultation on hypertension prevention and control held in abu dhabi, united arab emirates, 2022 december 2003, acknowledged the need for a standardized response to the growing challenge of hypertension see annex 1. Pdf secondary hypertension occurs in 510% of cases in the patient population with primary hypertension. Secondary hypertension symptoms and causes mayo clinic. Primary hypertension definition causes symptoms risk. After clinic measurements are confirmed, secondary causes of hypertension require consideration. Detailed summary from the 2017 guideline for the prevention.
Causes include renal disease, genetic causes, renal vascular hypertension, primary. Chronic kidney disease ckd is a common cause of high blood pressure, as the kidneys no longer filter. Conditions that may cause secondary hypertension include kidney disease, adrenal disease, thyroid problems and. Hypertension and serious mental illness hypertension high blood pressure is a common conditionaffecting 1 in 5 americansin which blood does not flow easily through the bodys blood. Coexistence of hypertension and related chronic conditions 11. Chronic kidney disease ckd is a common cause of high blood pressure, as the kidneys no.
Diagnosis of secondary hypertension with investigations nursing diagnosis for high blood pressure secondary hypertension differential diagnosis diagnosis high blood pressure age of patients of secondary hypertension may be 50 years. Secondary hypertension the prevalence of secondary hypertension is around 56% of all hypertensives. The diagnosis of essential and secondary hypertension in. Hypertension is estimated to affect up to 65 million adults in the usa. Likely a complex interaction between multiple risk factorscauses in many cases. See box 351 for factors that suggest the presence of secondary hypertension, and table 352 for etiologies and screening techniques. Pdf secondary hypertension, issues in diagnosis and treatment. Hypertension types hypertension center everyday health. Hypertension causes and treatment flashcards quizlet. Secondary hypertension t chronic glomerulonephritis. However, the decision to do surgery is often guided by the age and general health of the patient. Secondary hypertension has specific causes and is a complication of another health problem. Clinical assessment of hypertension in children clinical. Secondary hypertension an overview sciencedirect topics.
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