Nadciśnienie wtórne
Objawy
Nadciśnienie wtórne, stanowiące około 5-10% wszystkich przypadków nadciśnienia tętniczego, charakteryzuje się brakiem specyficznych objawów, nawet przy bardzo wysokich wartościach ciśnienia, takich jak ciśnienie skurczowe >180 mmHg i/lub rozkurczowe >120 mmHg, które mogą prowadzić do przełomu nadciśnieniowego z objawami neurologicznymi, kardiologicznymi i nerkowymi. Diagnostyka powinna uwzględniać objawy choroby podstawowej, np. podwyższony poziom kreatyniny i białkomocz w chorobach nerek, napadowe zwyżki ciśnienia i objawy katecholaminowe w guzie chromochłonnym, cechy zespołu Cushinga, pierwotnego hiperaldosteronizmu, nadczynności lub niedoczynności tarczycy oraz obturacyjnego bezdechu sennego. Wskazania do podejrzenia nadciśnienia wtórnego obejmują nadciśnienie oporne na leczenie (ciśnienie >140/90 mmHg pomimo stosowania co najmniej trzech leków, w tym diuretyku), nagły początek nadciśnienia przed 30. lub po 55. roku życia, brak wywiadu rodzinnego i otyłości oraz szybki rozwój powikłań narządowych.
Objawy nadciśnienia wtórnego
Nadciśnienie wtórne, podobnie jak pierwotne, zazwyczaj nie wywołuje specyficznych objawów, nawet jeśli wartości ciśnienia tętniczego osiągają niebezpiecznie wysoki poziom123. Większość pacjentów z nadciśnieniem wtórnym może przez lata nie wiedzieć o swojej chorobie, dopóki nie zostanie ona wykryta podczas rutynowej kontroli ciśnienia krwi45.
W rzadkich przypadkach, gdy ciśnienie krwi osiąga bardzo wysokie wartości, mogą wystąpić pewne objawy, które jednak nie są specyficzne dla nadciśnienia wtórnego. Do objawów tych należą67:
- Bóle głowy, szczególnie w tylnej części głowy i rano8
- Duszność
- Krwawienia z nosa
- Zawroty głowy
- Szum w uszach
- Zaburzenia widzenia
- Zaburzenia snu
- Zaburzenia potencji (dysfunkcja erekcyjna)
Przy bardzo wysokich wartościach ciśnienia tętniczego (tzw. przełom nadciśnieniowy), gdy ciśnienie skurczowe przekracza 180 mmHg i/lub ciśnienie rozkurczowe przekracza 120 mmHg, mogą wystąpić poważniejsze objawy wymagające natychmiastowej interwencji medycznej1011:
- Silne bóle głowy
- Silny niepokój
- Duszność
- Ból w klatce piersiowej
- Nudności, wymioty
- Splątanie, dezorientacja
- Zaburzenia mowy
- Osłabienie jednej strony ciała
- Zaburzenia widzenia
- Krew w moczu
Objawy związane z chorobą podstawową
Charakterystyczną cechą nadciśnienia wtórnego jest to, że pacjenci mogą doświadczać objawów związanych z chorobą podstawową, która jest przyczyną nadciśnienia1415. Te dodatkowe objawy mogą pomóc w diagnozie:
- Choroby nerek: podwyższony poziom kreatyniny we krwi, białkomocz, obrzęki16
- Guz chromochłonny (pheochromocytoma): napadowe zwyżki ciśnienia, pocenie się, kołatanie serca, silny niepokój, utrata wagi1718
- Zespół Cushinga: przyrost masy ciała, osłabienie mięśniowe, twarz księżycowata, nieprawidłowy wzrost owłosienia, fioletowe rozstępy na brzuchu1920
- Pierwotny hiperaldosteronizm: osłabienie związane z niskim poziomem potasu we krwi21
- Nadczynność przytarczyc: zmęczenie, zwiększone oddawanie moczu, zaparcia, kamienie nerkowe22
- Choroby tarczycy: niedoczynność tarczycy może powodować podwyższenie ciśnienia rozkurczowego, a nadczynność tarczycy – ciśnienia skurczowego; inne objawy to zmęczenie, uczucie zimna, przyrost masy ciała, zaparcia, wypadanie włosów, sucha skóra (w niedoczynności) lub uczucie gorąca, drżenia, przyspieszone bicie serca, utrata wagi (w nadczynności)2324
- Obturacyjny bezdech senny: chrapanie, senność w ciągu dnia, poranne lub nocne nadciśnienie, dezorientacja, depresja lub drażliwość25
Cechy charakterystyczne nadciśnienia wtórnego
Nadciśnienie wtórne może być podejrzewane przez lekarzy na podstawie pewnych charakterystycznych cech klinicznych. Sygnały ostrzegawcze, które mogą sugerować wtórną przyczynę nadciśnienia, obejmują262728:
- Nadciśnienie oporne na leczenie – ciśnienie tętnicze pozostaje podwyższone (>140/90 mmHg) pomimo stosowania optymalnych dawek co najmniej trzech leków przeciwnadciśnieniowych z różnych klas, w tym diuretyku29
- Bardzo wysokie wartości ciśnienia – ciśnienie skurczowe powyżej 180 mmHg lub ciśnienie rozkurczowe powyżej 120 mmHg30
- Utrata skuteczności leków – ciśnienie krwi przestaje reagować na leki, które wcześniej skutecznie je kontrolowały31
- Nagły początek nadciśnienia przed 30. rokiem życia lub po 55. roku życia32
- Brak wywiadu rodzinnego w kierunku nadciśnienia tętniczego33
- Brak otyłości34
- Nadciśnienie złośliwe lub przyspieszone z szybkim rozwojem powikłań narządowych35
- Nagły wzrost ciśnienia u pacjentów z wcześniej stabilnymi wartościami3637
Warto podkreślić, że nadciśnienie wtórne stanowi tylko około 5-10% wszystkich przypadków nadciśnienia tętniczego3839. Jednak jego częstość występowania jest wyższa w określonych grupach pacjentów, np. u młodych osób w wieku 18-40 lat z nadciśnieniem, częstość występowania nadciśnienia wtórnego może sięgać nawet 30%40.
Nadciśnienie wtórne u dzieci
U dzieci nadciśnienie wtórne występuje znacznie częściej niż u dorosłych. Nawet do 70-85% przypadków nadciśnienia u dzieci ma zidentyfikowaną przyczynę wtórną41. Najczęstszymi przyczynami są:
- Choroby miąższu nerek, które są najczęstszą przyczyną nadciśnienia u dzieci w wieku przedpokwitaniowym42
- Koarktacja aorty – druga najczęstsza przyczyna, występująca 2-5 razy częściej u chłopców43
Czerwoną flagą wskazującą na konieczność poszukiwania przyczyn wtórnych nadciśnienia jest wystąpienie wysokiego ciśnienia krwi przed okresem dojrzewania44. Z tego powodu wszystkie dzieci z potwierdzonym nadciśnieniem powinny przejść badania w kierunku przyczyn wtórnych, obejmujące co najmniej badanie ultrasonograficzne nerek45.
Progresja nadciśnienia wtórnego
Nieleczone nadciśnienie wtórne może prowadzić do poważnych powikłań zdrowotnych oraz pogłębiać chorobę podstawową, która jest jego przyczyną4647. Progresja nadciśnienia wtórnego może obejmować:
Powikłania sercowo-naczyniowe
Długotrwałe, niekontrolowane nadciśnienie wtórne może prowadzić do4849:
- Uszkodzenia tętnic – stwardnienie i pogrubienie tętnic (miażdżyca), które może prowadzić do zawału serca, udaru mózgu lub innych powikłań
- Tętniaka – osłabienia i uwypuklenia ściany tętnicy
- Niewydolności serca – serce powiększa się i jego ściany grubieją, ponieważ musi pracować ciężej, aby pompować krew; te zmiany w sercu mogą prowadzić do zaburzeń rytmu serca lub niewydolności serca50
Powikłania nerkowe
Nadciśnienie wtórne może prowadzić do51:
- Osłabienia i zwężenia naczyń krwionośnych w nerkach
- Postępującego uszkodzenia nerek, które może prowadzić do niewydolności nerek
Warto zauważyć, że nadciśnienie tętnicze może być główną przyczyną uszkodzenia nerek, szczególnie u osób starszych, co z kolei prowadzi do pogorszenia nadciśnienia52. Tworzy to błędne koło, w którym nadciśnienie i choroba nerek wzajemnie się nasilają.
Powikłania neurologiczne
Bez odpowiedniego leczenia, nadciśnienie wtórne może wpływać na mózg, powodując5354:
- Problemy z pamięcią lub zrozumieniem pojęć
- Trudności poznawcze
- Demencję naczyniową
Ciężkie nadciśnienie może powodować obrzęk mózgu, co prowadzi do nudności, wymiotów, nasilającego się bólu głowy, senności, dezorientacji, drgawek, a nawet śpiączki55.
Powikłania okulistyczne
Nadciśnienie wtórne może również wpływać na oczy, powodując56:
- Pogrubienie, zwężenie lub rozdarcie naczyń krwionośnych w oczach
- Retinopatię nadciśnieniową
- Zaburzenia widzenia
Zespół metaboliczny
Długotrwałe nadciśnienie wtórne może przyczyniać się do rozwoju zespołu metabolicznego57.
Rokowanie w nadciśnieniu wtórnym
Rokowanie w nadciśnieniu wtórnym jest generalnie korzystne, pod warunkiem wczesnego wykrycia i leczenia choroby podstawowej5859. W wielu przypadkach nadciśnienie wtórne może być całkowicie wyleczone, gdy skutecznie leczona jest jego pierwotna przyczyna6061.
Nadciśnienie wtórne, które nie jest właściwie diagnozowane i leczone, może prowadzić do62:
- Wczesnego uszkodzenia narządów docelowych
- Przełomów nadciśnieniowych
- Incydentów sercowo-naczyniowych w młodszym wieku
Ważne jest, aby zauważyć, że nadciśnienie wtórne jest zwykle oporne na standardowe leki przeciwnadciśnieniowe, jeśli nie zostanie zidentyfikowany i odpowiednio leczony mechanizm podstawowy63. Dlatego też wczesna i dokładna diagnoza oraz odpowiednie leczenie choroby podstawowej są kluczowe dla poprawy rokowania.
Przykładowo, wczesne wykrycie i leczenie pierwotnego hiperaldosteronizmu jest szczególnie istotne, ponieważ pacjenci z tym schorzeniem mają wyższe ryzyko chorobowości i śmiertelności sercowo-naczyniowej niż inni pacjenci z nadciśnieniem tętniczym dopasowani pod względem wieku, płci i ciśnienia krwi64.
W przypadku nadciśnienia wtórnego spowodowanego wadami naczyniowymi, takimi jak zwężenie tętnicy nerkowej, zabieg przezskórnej rewaskularyzacji może znacznie poprawić kontrolę ciśnienia krwi65. Podobnie, w przypadku nadciśnienia wywołanego przez obturacyjny bezdech senny, leczenie podstawowego zaburzenia snu może prowadzić do poprawy kontroli ciśnienia krwi66.
Ogólnie rzecz biorąc, wczesne wykrycie i leczenie nadciśnienia wtórnego może zmniejszyć ryzyko uszkodzenia naczyń krwionośnych i serca spowodowanego długotrwałym wysokim ciśnieniem krwi67.
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Materiały źródłowe
- #1 Secondary hypertension – Symptoms & causes – Mayo Clinichttps://www.mayoclinic.org/diseases-conditions/secondary-hypertension/symptoms-causes/syc-20350679
Secondary high blood pressure (secondary hypertension) is high blood pressure that’s caused by another medical condition. […] Like primary hypertension, secondary hypertension usually has no specific symptoms, even if blood pressure has reached dangerously high levels. […] For people diagnosed with high blood pressure, having any of these signs may mean the condition is secondary hypertension: High blood pressure that doesn’t respond to blood pressure medications (resistant hypertension) […] Very high blood pressure systolic blood pressure over 180 millimeters of mercury (mm Hg) or diastolic blood pressure over 120 millimeters of mercury (mm Hg) […] High blood pressure that no longer responds to medication that previously controlled the blood pressure […] Sudden-onset high blood pressure before age 30 or after age 55
- #2 High blood pressure (hypertension) – Symptoms & causes – Mayo Clinichttps://www.mayoclinic.org/diseases-conditions/high-blood-pressure/symptoms-causes/syc-20373410
Most people with high blood pressure have no symptoms, even if blood pressure readings reach dangerously high levels. You can have high blood pressure for years without any symptoms. […] A few people with high blood pressure may have: Headaches, Shortness of breath, Nosebleeds. […] However, these symptoms aren’t specific. They usually don’t occur until high blood pressure has reached a severe or life-threatening stage. […] This type of high blood pressure is caused by an underlying condition. It tends to appear suddenly and cause higher blood pressure than does primary hypertension.
- #3 Secondary hypertension | Beacon Health Systemhttps://www.beaconhealthsystem.org/library/diseases-and-conditions/secondary-hypertension?content_id=CON-20155139
Secondary hypertension usually has no specific symptoms, even if blood pressure has reached dangerously high levels. […] For people diagnosed with high blood pressure, having any of these signs may mean the condition is secondary hypertension: High blood pressure that doesn’t respond to blood pressure medications (resistant hypertension), very high blood pressure systolic blood pressure over 180 millimeters of mercury (mm Hg) or diastolic blood pressure over 120 mm Hg, high blood pressure that no longer responds to medication that previously controlled the blood pressure, sudden-onset high blood pressure before age 30 or after age 55, no family history of high blood pressure, no obesity. […] Secondary hypertension can worsen the underlying medical condition that’s causing the high blood pressure. Without treatment, secondary hypertension can lead to other health problems, such as damage to arteries, aneurysm, heart failure, weakened and narrowed blood vessels in the kidneys, thickened, narrowed or torn blood vessels in the eyes, metabolic syndrome, trouble with memory or understanding.
- #4 High blood pressure – NHShttps://www.nhs.uk/conditions/high-blood-pressure/
High blood pressure does not usually cause any symptoms. […] Many people have it without realising it. […] Rarely, high blood pressure can cause symptoms such as headaches, blurred vision, and chest pain. […] But the only way to find out if you have high blood pressure is to get your blood pressure checked. […] You often have headaches or blurred vision. […] You have chest pain that comes and goes. […] You have other symptoms you’re worried could be caused by high blood pressure.
- #5 Hypertension: MedlinePlus GeneticsLockhttps://medlineplus.gov/genetics/condition/hypertension/
Hypertension usually has no symptoms, and many affected individuals do not know they have the condition. […] In rare cases, dangerously high blood pressure can cause severe headaches, confusion, shortness of breath, chest pain, or nosebleeds. […] When hypertension results from an underlying condition, such as blood vessel defects that reduce blood flow; kidney disorders, which alter the amount of fluids and salts in the body; or problems with hormone-producing glands called the adrenal glands or the thyroid gland, it is classified as secondary hypertension.
- #6 High blood pressure (hypertension) – Symptoms & causes – Mayo Clinichttps://www.mayoclinic.org/diseases-conditions/high-blood-pressure/symptoms-causes/syc-20373410
Most people with high blood pressure have no symptoms, even if blood pressure readings reach dangerously high levels. You can have high blood pressure for years without any symptoms. […] A few people with high blood pressure may have: Headaches, Shortness of breath, Nosebleeds. […] However, these symptoms aren’t specific. They usually don’t occur until high blood pressure has reached a severe or life-threatening stage. […] This type of high blood pressure is caused by an underlying condition. It tends to appear suddenly and cause higher blood pressure than does primary hypertension.
- #7 High Blood Pressure – Heart and Blood Vessel Disorders – Merck Manual Consumer Versionhttps://www.merckmanuals.com/home/heart-and-blood-vessel-disorders/high-blood-pressure/high-blood-pressure
In most people, high blood pressure causes no symptoms. […] However, in some cases when the blood pressure elevation is severe (defined as systolic blood pressure 180 mm Hg and/or diastolic blood pressure 120 mm Hg) and untreated, it can lead to symptoms caused by damage to the brain, eyes, heart, and kidneys. […] People who develop such symptoms and have severely elevated blood pressure have a hypertensive emergency and require emergency treatment. […] The symptoms can include nausea, vomiting, shortness of breath, restlessness, and an unusual or unexplained headache or fatigue. […] Severe high blood pressure increases the workload of the heart and may cause chest pain and/or shortness of breath. […] Long-standing high blood pressure can damage the heart and blood vessels and increase the risk of heart attack, heart failure, kidney failure, stroke, and vascular dementia.
- #8 High blood pressure: symptoms, causes and therapieshttps://medconsonline.com/en/blog/arterial-hypertension
Due to the fact that in most cases the disease does not manifest itself in any way, it is considered particularly dangerous. People suffering from it at first almost do not notice any health decline, so the diagnosis is usually made only at advanced stages, or in connection with secondary conditions. The exception is a severe increase in blood pressure, often called a hypertensive crisis, which can lead to dizziness and visual disturbances. […] Arterial hypertension may be indicated by the following signs: headache with mental or physical stress; morning pain in the back of the head; frequent dizziness; ringing in the ears; nosebleeds; shortness of breath during exercise or at rest; palpitations; recurrent visual disturbances, such as blurred vision; sleep disturbances; potency disorder (erectile dysfunction). […] If arterial hypertension becomes chronic, there is reason to assume the presence of hypertension – a widespread (especially in industrialized countries) and dangerous disease.
- #9 Primary Hypertension vs Secondary Hypertensionhttps://plushcare.com/blog/primary-hypertension-vs-secondary-hypertension/
Secondary hypertension symptoms usually come on abruptly, are severe and resistant, and are associated with endocrine disorders, electrolyte imbalances, or prescription medications. […] Symptoms may include: Severe or resistant hypertension (high blood pressure despite medication management), An acute, sudden rise in blood pressure, Low potassium in blood work, High levels of creatinine in blood work. […] Symptoms that are signs of a serious type of blood pressure that need to be treated as soon as possible include: Severe headache, Chest pain, Severe pain in your upper back, Problems breathing, Nausea or vomiting, Vision changes, Blood in your urine, Confusion, Problems speaking, Weakness on one side of your body.
- #10 High Blood Pressure – Heart and Blood Vessel Disorders – Merck Manual Consumer Versionhttps://www.merckmanuals.com/home/heart-and-blood-vessel-disorders/high-blood-pressure/high-blood-pressure
In most people, high blood pressure causes no symptoms. […] However, in some cases when the blood pressure elevation is severe (defined as systolic blood pressure 180 mm Hg and/or diastolic blood pressure 120 mm Hg) and untreated, it can lead to symptoms caused by damage to the brain, eyes, heart, and kidneys. […] People who develop such symptoms and have severely elevated blood pressure have a hypertensive emergency and require emergency treatment. […] The symptoms can include nausea, vomiting, shortness of breath, restlessness, and an unusual or unexplained headache or fatigue. […] Severe high blood pressure increases the workload of the heart and may cause chest pain and/or shortness of breath. […] Long-standing high blood pressure can damage the heart and blood vessels and increase the risk of heart attack, heart failure, kidney failure, stroke, and vascular dementia.
- #11 Symptoms of Resistant Hypertension | Stanford Health Carehttps://stanfordhealthcare.org/medical-conditions/blood-heart-circulation/resistant-hypertension/symptoms.html
Sometimes, your blood can push too forcefully against your arteries as your heart pumps. If that happens, it could be a sign of high blood pressure or hypertension. […] Despite the potential to cause dangerous complications, high blood pressure often goes unrecognized. It does not usually cause obvious symptoms, making regular checkups essential. When blood pressure rises extremely high (systolic pressure of 180 mm Hg or above, diastolic pressure of 110 mm Hg or above), it causes a hypertensive emergency and certain symptoms: […] Severe headaches […] Severe anxiety […] Shortness of breath […] Nosebleeds.
- #12 Primary Hypertension vs Secondary Hypertensionhttps://plushcare.com/blog/primary-hypertension-vs-secondary-hypertension/
Secondary hypertension symptoms usually come on abruptly, are severe and resistant, and are associated with endocrine disorders, electrolyte imbalances, or prescription medications. […] Symptoms may include: Severe or resistant hypertension (high blood pressure despite medication management), An acute, sudden rise in blood pressure, Low potassium in blood work, High levels of creatinine in blood work. […] Symptoms that are signs of a serious type of blood pressure that need to be treated as soon as possible include: Severe headache, Chest pain, Severe pain in your upper back, Problems breathing, Nausea or vomiting, Vision changes, Blood in your urine, Confusion, Problems speaking, Weakness on one side of your body.
- #13 Endocrine Related Hypertension | Endocrine Societyhttps://www.endocrine.org/patient-engagement/endocrine-library/endocrine-related-hypertension
In addition, an acute elevation in blood pressure to 180/120 mm Hg can acutely cause a heart attack, stroke, brain bleed, rupture of the large blood vessel from the heart (aorta), and/or kidney damage. Since these complications are life-threatening, call 9-1-1 if you are having new severe symptoms such as the following: headache, chest pain, shortness of breath, back pain, vision changes, or symptoms of a stroke such as trouble talking, arm or leg weakness, or facial droop. […] In terms of secondary hypertension, treatment of obstructive sleep apnea and kidney disease is important to improve blood pressure and lower the risk of heart attack and stroke. For patients with endocrine-related hypertension, surgery or medications that affect specific hormones in the body can greatly improve or even cure secondary hypertension.
- #14 Secondary Hypertension: Causes & Symptomshttps://my.clevelandclinic.org/health/diseases/21128-secondary-hypertension
Secondary hypertension itself usually doesn’t have symptoms (unless your blood pressure is very high). But you may develop symptoms from the underlying condition that’s causing it. […] Your healthcare provider may suspect secondary hypertension if: […] Another red flag is high blood pressure that starts before puberty. If this happens to your child, their pediatrician may look for secondary causes. […] Untreated, secondary hypertension can lead to hypertensive heart disease. This is damage to your heart that results from years of high blood pressure. You may also develop complications from the condition that’s raising your blood pressure. […] Secondary hypertension has a positive outlook with treatment. Early detection and treatment can lower the risk of damage to your blood vessels and heart from ongoing high blood pressure.
- #15 Secondary hypertension Guide: Causes, Symptoms and Treatment Optionshttps://www.drugs.com/health-guide/secondary-hypertension.html
Most often doctors start to consider secondary hypertension when blood pressure is not controlled with two or three different medications or if the person has symptoms related to the underlying condition. […] For example, a tumor of the adrenal gland called a pheochromocytoma can cause sweating, palpitations, severe anxiety and weight loss. In Cushing’s syndrome, there may be weight gain, weakness, abnormal growth of body hair and loss of menstrual periods in women, and the appearance of purple „stretch marks” on the abdomen (abdominal striae). Hyperparathyroidism with elevated calcium levels can cause fatigue, increased urination, constipation and kidney stones. Hyperaldosteronism often causes weakness related to low blood potassium levels. […] Inform you doctor if you have any of the symptoms associated with medical illnesses that cause secondary hypertension, such as unexplained weight change, palpitations, leg swelling (edema), marked fatigue, abnormal hair growth or new purplish stretch marks on your skin. […] In many patients with secondary hypertension, high blood pressure can be cured when their underlying medical illness is treated successfully.
- #16 Secondary Hypertension: Discovering the Underlying Cause | AAFPhttps://www.aafp.org/pubs/afp/issues/2017/1001/p453.html
Hypertension can be a major cause of renal failure in older adults, which in turn leads to worsening hypertension. […] Secondary hypertension in these cases is suggested by an elevated serum creatinine level or proteinuria on urinalysis. […] Primary hyperaldosteronism is excess production of aldosterone independent of the renin-angiotensin system and is caused by an adrenal adenoma, unilateral or bilateral adrenal hyperplasia, or adrenocortical carcinoma. […] OSA is a leading treatable cause of secondary hypertension. […] Pheochromocytoma should be suspected when there are paroxysmal elevations in blood pressure. […] Cushing syndrome has classical features of moon facies, central obesity, proximal muscle weakness, and ecchymosis. […] Coarctation of the aorta is a common cause of secondary hypertension in children, especially males, but may not be detected until adulthood because it is often asymptomatic. […] Hypothyroidism can cause an elevation in diastolic blood pressure, whereas hyperthyroidism can cause an elevation of systolic blood pressure, leading to a widened pulse pressure.
- #17 Secondary hypertension Guide: Causes, Symptoms and Treatment Optionshttps://www.drugs.com/health-guide/secondary-hypertension.html
Most often doctors start to consider secondary hypertension when blood pressure is not controlled with two or three different medications or if the person has symptoms related to the underlying condition. […] For example, a tumor of the adrenal gland called a pheochromocytoma can cause sweating, palpitations, severe anxiety and weight loss. In Cushing’s syndrome, there may be weight gain, weakness, abnormal growth of body hair and loss of menstrual periods in women, and the appearance of purple „stretch marks” on the abdomen (abdominal striae). Hyperparathyroidism with elevated calcium levels can cause fatigue, increased urination, constipation and kidney stones. Hyperaldosteronism often causes weakness related to low blood potassium levels. […] Inform you doctor if you have any of the symptoms associated with medical illnesses that cause secondary hypertension, such as unexplained weight change, palpitations, leg swelling (edema), marked fatigue, abnormal hair growth or new purplish stretch marks on your skin. […] In many patients with secondary hypertension, high blood pressure can be cured when their underlying medical illness is treated successfully.
- #18 Endocrine Related Hypertension | Endocrine Societyhttps://www.endocrine.org/patient-engagement/endocrine-library/endocrine-related-hypertension
Secondary hypertension is due to medical conditions such as kidney disease and obstructive sleep apnea, as well as endocrine disorders such as primary aldosteronism, Cushings syndrome, and pheochromocytoma. […] Pheochromocytoma is a rare cause of secondary hypertension caused when the body makes too much of hormones similar to adrenaline. In addition to high blood pressure, pheochromocytomas can present with episodes of headache, sweating, and a racing heartbeat. […] Cushings syndrome is another rare cause of secondary hypertension caused when the adrenal glands make too much of the hormone cortisol. In addition to high blood pressure, it can present with weight gain in the trunk, muscle weakness, and purple stretch marks. […] Both low thyroid hormone levels (hypothyroidism) and high thyroid hormone levels (hyperthyroidism) can cause high blood pressure. Hypothyroidism typically elevates the diastolic pressure more than the systolic pressure, whereas hyperthyroidism typically elevates the systolic pressure more than the diastolic pressure. Other symptoms of hypothyroidism include fatigue, feeling cold all the time, weight gain, constipation, hair loss, and dry skin. Other symptoms of hyperthyroidism include feeling hot all the time, tremors, racing heartbeat, and weight loss.
- #19 Secondary hypertension Guide: Causes, Symptoms and Treatment Optionshttps://www.drugs.com/health-guide/secondary-hypertension.html
Most often doctors start to consider secondary hypertension when blood pressure is not controlled with two or three different medications or if the person has symptoms related to the underlying condition. […] For example, a tumor of the adrenal gland called a pheochromocytoma can cause sweating, palpitations, severe anxiety and weight loss. In Cushing’s syndrome, there may be weight gain, weakness, abnormal growth of body hair and loss of menstrual periods in women, and the appearance of purple „stretch marks” on the abdomen (abdominal striae). Hyperparathyroidism with elevated calcium levels can cause fatigue, increased urination, constipation and kidney stones. Hyperaldosteronism often causes weakness related to low blood potassium levels. […] Inform you doctor if you have any of the symptoms associated with medical illnesses that cause secondary hypertension, such as unexplained weight change, palpitations, leg swelling (edema), marked fatigue, abnormal hair growth or new purplish stretch marks on your skin. […] In many patients with secondary hypertension, high blood pressure can be cured when their underlying medical illness is treated successfully.
- #20 Secondary hypertension – Wikipediahttps://en.wikipedia.org/wiki/Secondary_hypertension
Secondary hypertension (or, less commonly, inessential hypertension) is a type of hypertension which has a specific and identifiable underlying primary cause. It is much less common than essential hypertension, affecting only 5-10% of hypertensive patients. […] Hypertension is common in chronic kidney disease. […] More than 80% of patients with Cushing’s syndrome develop hypertension, which is accompanied by distinct symptoms of the syndrome, such as central obesity, lipodystrophy, moon face, sweating, hirsutism and anxiety. […] The increases in blood pressure may result in blood pressures greater than when the medication was initiated. Depending on the severity of the increase in blood pressure, rebound hypertension may result in a hypertensive emergency. […] Few women of childbearing age have high blood pressure, up to 11% develop hypertension of pregnancy.
- #21 Secondary hypertension Guide: Causes, Symptoms and Treatment Optionshttps://www.drugs.com/health-guide/secondary-hypertension.html
Most often doctors start to consider secondary hypertension when blood pressure is not controlled with two or three different medications or if the person has symptoms related to the underlying condition. […] For example, a tumor of the adrenal gland called a pheochromocytoma can cause sweating, palpitations, severe anxiety and weight loss. In Cushing’s syndrome, there may be weight gain, weakness, abnormal growth of body hair and loss of menstrual periods in women, and the appearance of purple „stretch marks” on the abdomen (abdominal striae). Hyperparathyroidism with elevated calcium levels can cause fatigue, increased urination, constipation and kidney stones. Hyperaldosteronism often causes weakness related to low blood potassium levels. […] Inform you doctor if you have any of the symptoms associated with medical illnesses that cause secondary hypertension, such as unexplained weight change, palpitations, leg swelling (edema), marked fatigue, abnormal hair growth or new purplish stretch marks on your skin. […] In many patients with secondary hypertension, high blood pressure can be cured when their underlying medical illness is treated successfully.
- #22 Secondary hypertension Guide: Causes, Symptoms and Treatment Optionshttps://www.drugs.com/health-guide/secondary-hypertension.html
Most often doctors start to consider secondary hypertension when blood pressure is not controlled with two or three different medications or if the person has symptoms related to the underlying condition. […] For example, a tumor of the adrenal gland called a pheochromocytoma can cause sweating, palpitations, severe anxiety and weight loss. In Cushing’s syndrome, there may be weight gain, weakness, abnormal growth of body hair and loss of menstrual periods in women, and the appearance of purple „stretch marks” on the abdomen (abdominal striae). Hyperparathyroidism with elevated calcium levels can cause fatigue, increased urination, constipation and kidney stones. Hyperaldosteronism often causes weakness related to low blood potassium levels. […] Inform you doctor if you have any of the symptoms associated with medical illnesses that cause secondary hypertension, such as unexplained weight change, palpitations, leg swelling (edema), marked fatigue, abnormal hair growth or new purplish stretch marks on your skin. […] In many patients with secondary hypertension, high blood pressure can be cured when their underlying medical illness is treated successfully.
- #23 Endocrine Related Hypertension | Endocrine Societyhttps://www.endocrine.org/patient-engagement/endocrine-library/endocrine-related-hypertension
Secondary hypertension is due to medical conditions such as kidney disease and obstructive sleep apnea, as well as endocrine disorders such as primary aldosteronism, Cushings syndrome, and pheochromocytoma. […] Pheochromocytoma is a rare cause of secondary hypertension caused when the body makes too much of hormones similar to adrenaline. In addition to high blood pressure, pheochromocytomas can present with episodes of headache, sweating, and a racing heartbeat. […] Cushings syndrome is another rare cause of secondary hypertension caused when the adrenal glands make too much of the hormone cortisol. In addition to high blood pressure, it can present with weight gain in the trunk, muscle weakness, and purple stretch marks. […] Both low thyroid hormone levels (hypothyroidism) and high thyroid hormone levels (hyperthyroidism) can cause high blood pressure. Hypothyroidism typically elevates the diastolic pressure more than the systolic pressure, whereas hyperthyroidism typically elevates the systolic pressure more than the diastolic pressure. Other symptoms of hypothyroidism include fatigue, feeling cold all the time, weight gain, constipation, hair loss, and dry skin. Other symptoms of hyperthyroidism include feeling hot all the time, tremors, racing heartbeat, and weight loss.
- #24 Diagnosis of Secondary Hypertension: An Age-Based Approach | AAFPhttps://www.aafp.org/pubs/afp/issues/2010/1215/p1471.html
Hypothyroidism can cause an elevation in diastolic blood pressure, whereas hyperthyroidism can cause an isolated elevation of systolic blood pressure, leading to a widened pulse pressure. […] Primary aldosteronism, also referred to as hyperaldosteronism, is actually a group of conditions, including aldosterone-producing adenomas and bilateral idiopathic hyperaldosteronism. […] Obstructive sleep apnea is a notable cause of secondary hypertension, particularly in 40- to 59-year-olds, but less so in those 60 years and older. […] Pheochromocytomas are rare tumors responsible for approximately 0.5 percent of cases of secondary hypertension. […] Renal artery stenosis secondary to atherosclerotic disease affects older adults. […] Hypertension can be a major cause of renal parenchymal damage, particularly in older adults, which in turn leads to worsening hypertension.
- #25https://healthmatch.io/high-blood-pressure/what-is-secondary-hypertension
Symptoms of pheochromocytoma include: High blood pressure, Fatigue, Headaches, Fast heart rate, Weight loss, Shortness of breath. […] Symptoms include: Headache, Shortness of breath, Chest pain, Exercise intolerance, Nose bleeds, Hard-to-control high blood pressure, Cold feet or leg pain after exercising. […] Symptoms may include: Snoring, Daytime sleepiness, Morning or night-time hypertension, Confusion, Headaches, Depression or irritability. […] The key to treating secondary hypertension is treating the underlying medical condition. Once you receive treatment for the underlying condition, you may be able to manage your hypertension easily.
- #26 Secondary hypertension – Symptoms & causes – Mayo Clinichttps://www.mayoclinic.org/diseases-conditions/secondary-hypertension/symptoms-causes/syc-20350679
Secondary high blood pressure (secondary hypertension) is high blood pressure that’s caused by another medical condition. […] Like primary hypertension, secondary hypertension usually has no specific symptoms, even if blood pressure has reached dangerously high levels. […] For people diagnosed with high blood pressure, having any of these signs may mean the condition is secondary hypertension: High blood pressure that doesn’t respond to blood pressure medications (resistant hypertension) […] Very high blood pressure systolic blood pressure over 180 millimeters of mercury (mm Hg) or diastolic blood pressure over 120 millimeters of mercury (mm Hg) […] High blood pressure that no longer responds to medication that previously controlled the blood pressure […] Sudden-onset high blood pressure before age 30 or after age 55
- #27 Secondary Hypertension: Discovering the Underlying Cause | AAFPhttps://www.aafp.org/pubs/afp/issues/2017/1001/p453.html
Secondary hypertension should be considered in the presence of suggestive symptoms and signs, such as severe or resistant hypertension, age of onset younger than 30 years (especially before puberty), malignant or accelerated hypertension, and an acute rise in blood pressure from previously stable readings. […] Secondary hypertension is a type of hypertension with an underlying and potentially reversible cause. It makes up only a small fraction (5% to 10%) of hypertensive cases. […] The prevalence of secondary hypertension varies by age and is more common in younger persons, with a prevalence close to 30% in those 18 to 40 years of age with hypertension. […] Secondary hypertension should be considered in the presence of suggestive signs and symptoms such as severe or resistant hypertension, onset before 30 years of age (especially before puberty), malignant or accelerated hypertension, and an acute rise in blood pressure from previously stable readings.
- #28 Secondary hypertension | Beacon Health Systemhttps://www.beaconhealthsystem.org/library/diseases-and-conditions/secondary-hypertension?content_id=CON-20155139
Secondary hypertension usually has no specific symptoms, even if blood pressure has reached dangerously high levels. […] For people diagnosed with high blood pressure, having any of these signs may mean the condition is secondary hypertension: High blood pressure that doesn’t respond to blood pressure medications (resistant hypertension), very high blood pressure systolic blood pressure over 180 millimeters of mercury (mm Hg) or diastolic blood pressure over 120 mm Hg, high blood pressure that no longer responds to medication that previously controlled the blood pressure, sudden-onset high blood pressure before age 30 or after age 55, no family history of high blood pressure, no obesity. […] Secondary hypertension can worsen the underlying medical condition that’s causing the high blood pressure. Without treatment, secondary hypertension can lead to other health problems, such as damage to arteries, aneurysm, heart failure, weakened and narrowed blood vessels in the kidneys, thickened, narrowed or torn blood vessels in the eyes, metabolic syndrome, trouble with memory or understanding.
- #29 Secondary Hypertension – StatPearls – NCBI Bookshelfhttps://www.ncbi.nlm.nih.gov/sites/books/NBK544305/
Secondary hypertension is defined as elevated blood pressure (BP) secondary to an identifiable cause. […] The common clinical signs which warrant investigations for a secondary cause of hypertension may include; Resistant hypertension, i.e., persistent blood pressure greater than 140/90 mm Hg despite using optimal doses of at least three anti-hypertensive from different classes, that includes a diuretic. […] Development of hypertension in extremes of age accelerated end-organ dysfunction due to hypertension, resistant hypertension, and sudden rise in blood pressure in hypertensive individuals, who are stable on drug therapy, are classical features of secondary hypertension. […] Secondary hypertension is usually resistant to antihypertensive drugs if the underlying mechanism is not identified and treated appropriately. It may present with early end-organ dysfunction, hypertension crisis, and cardiovascular events at a younger age. […] However, with early identification and treatment of the underlying cause, secondary hypertension has a favorable prognosis.
- #30 Secondary hypertension | Beacon Health Systemhttps://www.beaconhealthsystem.org/library/diseases-and-conditions/secondary-hypertension?content_id=CON-20155139
Secondary hypertension usually has no specific symptoms, even if blood pressure has reached dangerously high levels. […] For people diagnosed with high blood pressure, having any of these signs may mean the condition is secondary hypertension: High blood pressure that doesn’t respond to blood pressure medications (resistant hypertension), very high blood pressure systolic blood pressure over 180 millimeters of mercury (mm Hg) or diastolic blood pressure over 120 mm Hg, high blood pressure that no longer responds to medication that previously controlled the blood pressure, sudden-onset high blood pressure before age 30 or after age 55, no family history of high blood pressure, no obesity. […] Secondary hypertension can worsen the underlying medical condition that’s causing the high blood pressure. Without treatment, secondary hypertension can lead to other health problems, such as damage to arteries, aneurysm, heart failure, weakened and narrowed blood vessels in the kidneys, thickened, narrowed or torn blood vessels in the eyes, metabolic syndrome, trouble with memory or understanding.
- #31 Secondary Hypertension Causes, Symptoms, Treatment, Morehttps://www.healthline.com/health/high-blood-pressure-hypertension/secondary-hypertension
Secondary hypertension does not cause any specific symptoms. You may not know you have this condition until you have a blood pressure exam. […] There are signs or symptoms that could indicate to your doctor that the hypertension is the result of another condition, however. These include: hypertension that’s resistant to medication, hypertension that no longer responds to medication, even if it previously worked, hypertension in a non-Black patient younger than 30 years old without any other risk factors (such as family history or obesity), hypertension in a person before puberty, the presence of high blood pressure complications, such as acute kidney damage, headache, or nausea. […] Secondary hypertension may not respond to medication alone. If the underlying cause is not identified, your blood pressure may remain high. In that case, it can still cause complications.
- #32 Secondary hypertension – Symptoms & causes – Mayo Clinichttps://www.mayoclinic.org/diseases-conditions/secondary-hypertension/symptoms-causes/syc-20350679
Secondary high blood pressure (secondary hypertension) is high blood pressure that’s caused by another medical condition. […] Like primary hypertension, secondary hypertension usually has no specific symptoms, even if blood pressure has reached dangerously high levels. […] For people diagnosed with high blood pressure, having any of these signs may mean the condition is secondary hypertension: High blood pressure that doesn’t respond to blood pressure medications (resistant hypertension) […] Very high blood pressure systolic blood pressure over 180 millimeters of mercury (mm Hg) or diastolic blood pressure over 120 millimeters of mercury (mm Hg) […] High blood pressure that no longer responds to medication that previously controlled the blood pressure […] Sudden-onset high blood pressure before age 30 or after age 55
- #33 Secondary hypertension – Symptoms & causes – Mayo Clinichttps://www.mayoclinic.org/diseases-conditions/secondary-hypertension/symptoms-causes/syc-20350679
No family history of high blood pressure […] No obesity. […] Secondary hypertension can worsen the underlying medical condition that’s causing the high blood pressure. Without treatment, secondary hypertension can lead to other health problems, such as: Damage to arteries. […] Heart failure. […] Trouble with memory or understanding. Uncontrolled high blood pressure also may affect the ability to think, remember and learn. Trouble with memory or understanding concepts is more common in people who have high blood pressure.
- #34 Secondary hypertension – Symptoms & causes – Mayo Clinichttps://www.mayoclinic.org/diseases-conditions/secondary-hypertension/symptoms-causes/syc-20350679
No family history of high blood pressure […] No obesity. […] Secondary hypertension can worsen the underlying medical condition that’s causing the high blood pressure. Without treatment, secondary hypertension can lead to other health problems, such as: Damage to arteries. […] Heart failure. […] Trouble with memory or understanding. Uncontrolled high blood pressure also may affect the ability to think, remember and learn. Trouble with memory or understanding concepts is more common in people who have high blood pressure.
- #35 Secondary Hypertension: Discovering the Underlying Cause | AAFPhttps://www.aafp.org/pubs/afp/issues/2017/1001/p453.html
Secondary hypertension should be considered in the presence of suggestive symptoms and signs, such as severe or resistant hypertension, age of onset younger than 30 years (especially before puberty), malignant or accelerated hypertension, and an acute rise in blood pressure from previously stable readings. […] Secondary hypertension is a type of hypertension with an underlying and potentially reversible cause. It makes up only a small fraction (5% to 10%) of hypertensive cases. […] The prevalence of secondary hypertension varies by age and is more common in younger persons, with a prevalence close to 30% in those 18 to 40 years of age with hypertension. […] Secondary hypertension should be considered in the presence of suggestive signs and symptoms such as severe or resistant hypertension, onset before 30 years of age (especially before puberty), malignant or accelerated hypertension, and an acute rise in blood pressure from previously stable readings.
- #36 Secondary Hypertension: Discovering the Underlying Cause | AAFPhttps://www.aafp.org/pubs/afp/issues/2017/1001/p453.html
Secondary hypertension should be considered in the presence of suggestive symptoms and signs, such as severe or resistant hypertension, age of onset younger than 30 years (especially before puberty), malignant or accelerated hypertension, and an acute rise in blood pressure from previously stable readings. […] Secondary hypertension is a type of hypertension with an underlying and potentially reversible cause. It makes up only a small fraction (5% to 10%) of hypertensive cases. […] The prevalence of secondary hypertension varies by age and is more common in younger persons, with a prevalence close to 30% in those 18 to 40 years of age with hypertension. […] Secondary hypertension should be considered in the presence of suggestive signs and symptoms such as severe or resistant hypertension, onset before 30 years of age (especially before puberty), malignant or accelerated hypertension, and an acute rise in blood pressure from previously stable readings.
- #37 Secondary Hypertension – StatPearls – NCBI Bookshelfhttps://www.ncbi.nlm.nih.gov/sites/books/NBK544305/
Secondary hypertension is defined as elevated blood pressure (BP) secondary to an identifiable cause. […] The common clinical signs which warrant investigations for a secondary cause of hypertension may include; Resistant hypertension, i.e., persistent blood pressure greater than 140/90 mm Hg despite using optimal doses of at least three anti-hypertensive from different classes, that includes a diuretic. […] Development of hypertension in extremes of age accelerated end-organ dysfunction due to hypertension, resistant hypertension, and sudden rise in blood pressure in hypertensive individuals, who are stable on drug therapy, are classical features of secondary hypertension. […] Secondary hypertension is usually resistant to antihypertensive drugs if the underlying mechanism is not identified and treated appropriately. It may present with early end-organ dysfunction, hypertension crisis, and cardiovascular events at a younger age. […] However, with early identification and treatment of the underlying cause, secondary hypertension has a favorable prognosis.
- #38 Secondary Hypertension: Discovering the Underlying Cause | AAFPhttps://www.aafp.org/pubs/afp/issues/2017/1001/p453.html
Secondary hypertension should be considered in the presence of suggestive symptoms and signs, such as severe or resistant hypertension, age of onset younger than 30 years (especially before puberty), malignant or accelerated hypertension, and an acute rise in blood pressure from previously stable readings. […] Secondary hypertension is a type of hypertension with an underlying and potentially reversible cause. It makes up only a small fraction (5% to 10%) of hypertensive cases. […] The prevalence of secondary hypertension varies by age and is more common in younger persons, with a prevalence close to 30% in those 18 to 40 years of age with hypertension. […] Secondary hypertension should be considered in the presence of suggestive signs and symptoms such as severe or resistant hypertension, onset before 30 years of age (especially before puberty), malignant or accelerated hypertension, and an acute rise in blood pressure from previously stable readings.
- #39 CV Physiology | Secondary Hypertensionhttps://cvphysiology.com/blood-pressure/bp023
Secondary hypertension accounts for approximately 5-10% of all cases of hypertension, with the remaining being primary hypertension. Secondary hypertension has an identifiable cause, whereas primary hypertension has no known cause (idiopathic). […] Patients with secondary hypertension are best treated by controlling or removing the underlying disease or pathology, although they may still require antihypertensive drugs. […] The elevation in arterial pressure secondary to renal disease can be viewed as an attempt by the kidney to increase renal perfusion and restore glomerular filtration. […] Prolonged elevation of angiotensin II and catecholamines can lead to cardiac and vascular hypertrophy, both of which can contribute to a sustained increase in blood pressure. […] These individuals have a higher incidence of hypertension.
- #40 Secondary Hypertension: Discovering the Underlying Cause | AAFPhttps://www.aafp.org/pubs/afp/issues/2017/1001/p453.html
Secondary hypertension should be considered in the presence of suggestive symptoms and signs, such as severe or resistant hypertension, age of onset younger than 30 years (especially before puberty), malignant or accelerated hypertension, and an acute rise in blood pressure from previously stable readings. […] Secondary hypertension is a type of hypertension with an underlying and potentially reversible cause. It makes up only a small fraction (5% to 10%) of hypertensive cases. […] The prevalence of secondary hypertension varies by age and is more common in younger persons, with a prevalence close to 30% in those 18 to 40 years of age with hypertension. […] Secondary hypertension should be considered in the presence of suggestive signs and symptoms such as severe or resistant hypertension, onset before 30 years of age (especially before puberty), malignant or accelerated hypertension, and an acute rise in blood pressure from previously stable readings.
- #41 Diagnosis of Secondary Hypertension: An Age-Based Approach | AAFPhttps://www.aafp.org/pubs/afp/issues/2010/1215/p1471.html
Obstructive sleep apnea can be a secondary cause of or contribute to hypertension. […] The most common etiologies in children, in whom 70 to 85 percent of cases of hypertension have a secondary cause, are different from those in older persons; therefore, an age-based approach to the differential diagnosis is recommended. […] Renal parenchymal disease is the most common cause of hypertension in preadolescent children. […] Coarctation of the aorta is the second most common cause of hypertension in children, and is two to five times more common in boys. […] Fibromuscular dysplasia is a vascular disorder of unknown etiology that has a predilection for the renal arteries, causing narrowing that leads to decreased renal perfusion. […] In young adults, particularly women, fibromuscular dysplasia is one of the most common causes of secondary hypertension.
- #42 Diagnosis of Secondary Hypertension: An Age-Based Approach | AAFPhttps://www.aafp.org/pubs/afp/issues/2010/1215/p1471.html
Obstructive sleep apnea can be a secondary cause of or contribute to hypertension. […] The most common etiologies in children, in whom 70 to 85 percent of cases of hypertension have a secondary cause, are different from those in older persons; therefore, an age-based approach to the differential diagnosis is recommended. […] Renal parenchymal disease is the most common cause of hypertension in preadolescent children. […] Coarctation of the aorta is the second most common cause of hypertension in children, and is two to five times more common in boys. […] Fibromuscular dysplasia is a vascular disorder of unknown etiology that has a predilection for the renal arteries, causing narrowing that leads to decreased renal perfusion. […] In young adults, particularly women, fibromuscular dysplasia is one of the most common causes of secondary hypertension.
- #43 Diagnosis of Secondary Hypertension: An Age-Based Approach | AAFPhttps://www.aafp.org/pubs/afp/issues/2010/1215/p1471.html
Obstructive sleep apnea can be a secondary cause of or contribute to hypertension. […] The most common etiologies in children, in whom 70 to 85 percent of cases of hypertension have a secondary cause, are different from those in older persons; therefore, an age-based approach to the differential diagnosis is recommended. […] Renal parenchymal disease is the most common cause of hypertension in preadolescent children. […] Coarctation of the aorta is the second most common cause of hypertension in children, and is two to five times more common in boys. […] Fibromuscular dysplasia is a vascular disorder of unknown etiology that has a predilection for the renal arteries, causing narrowing that leads to decreased renal perfusion. […] In young adults, particularly women, fibromuscular dysplasia is one of the most common causes of secondary hypertension.
- #44 Secondary Hypertension: Causes & Symptomshttps://my.clevelandclinic.org/health/diseases/21128-secondary-hypertension
Secondary hypertension itself usually doesn’t have symptoms (unless your blood pressure is very high). But you may develop symptoms from the underlying condition that’s causing it. […] Your healthcare provider may suspect secondary hypertension if: […] Another red flag is high blood pressure that starts before puberty. If this happens to your child, their pediatrician may look for secondary causes. […] Untreated, secondary hypertension can lead to hypertensive heart disease. This is damage to your heart that results from years of high blood pressure. You may also develop complications from the condition that’s raising your blood pressure. […] Secondary hypertension has a positive outlook with treatment. Early detection and treatment can lower the risk of damage to your blood vessels and heart from ongoing high blood pressure.
- #45 Diagnosis of Secondary Hypertension: An Age-Based Approach | AAFPhttps://www.aafp.org/pubs/afp/issues/2010/1215/p1471.html
In middle-aged adults, aldosteronism is the most common secondary cause of hypertension, and the recommended initial diagnostic test is an aldosterone/renin ratio. […] Up to 85 percent of children with hypertension have an identifiable cause, most often renal parenchymal disease. […] Therefore, all children with confirmed hypertension should have an evaluation for an underlying etiology that includes renal ultrasonography. […] Indications for further investigation into a possible secondary etiology in the absence of suggestive signs and symptoms include resistant hypertension (defined as elevated blood pressure despite patient adherence to optimal dosages of three antihypertensive agents, including a diuretic), early or late onset of hypertension, a severe or accelerated course, or specific drug intolerances.
- #46 Secondary hypertension – Symptoms & causes – Mayo Clinichttps://www.mayoclinic.org/diseases-conditions/secondary-hypertension/symptoms-causes/syc-20350679
No family history of high blood pressure […] No obesity. […] Secondary hypertension can worsen the underlying medical condition that’s causing the high blood pressure. Without treatment, secondary hypertension can lead to other health problems, such as: Damage to arteries. […] Heart failure. […] Trouble with memory or understanding. Uncontrolled high blood pressure also may affect the ability to think, remember and learn. Trouble with memory or understanding concepts is more common in people who have high blood pressure.
- #47 Secondary Hypertension Causes, Symptoms, Treatment, Morehttps://www.healthline.com/health/high-blood-pressure-hypertension/secondary-hypertension
Secondary hypertension does not cause any specific symptoms. You may not know you have this condition until you have a blood pressure exam. […] There are signs or symptoms that could indicate to your doctor that the hypertension is the result of another condition, however. These include: hypertension that’s resistant to medication, hypertension that no longer responds to medication, even if it previously worked, hypertension in a non-Black patient younger than 30 years old without any other risk factors (such as family history or obesity), hypertension in a person before puberty, the presence of high blood pressure complications, such as acute kidney damage, headache, or nausea. […] Secondary hypertension may not respond to medication alone. If the underlying cause is not identified, your blood pressure may remain high. In that case, it can still cause complications.
- #48 Secondary hypertension – Symptoms & causes – Mayo Clinichttps://www.mayoclinic.org/diseases-conditions/secondary-hypertension/symptoms-causes/syc-20350679
No family history of high blood pressure […] No obesity. […] Secondary hypertension can worsen the underlying medical condition that’s causing the high blood pressure. Without treatment, secondary hypertension can lead to other health problems, such as: Damage to arteries. […] Heart failure. […] Trouble with memory or understanding. Uncontrolled high blood pressure also may affect the ability to think, remember and learn. Trouble with memory or understanding concepts is more common in people who have high blood pressure.
- #49 Secondary hypertensionhttps://www.mymlc.com/health-information/diseases-and-conditions/s/secondary-hypertension/
Secondary hypertension can worsen the underlying medical condition you have that’s causing your high blood pressure. If you don’t receive treatment, secondary hypertension can lead to other health problems, such as: Damage to your arteries. This can result in hardening and thickening of the arteries (atherosclerosis), which can lead to a heart attack, stroke or other complications. […] To diagnose secondary hypertension, your doctor will first take a blood pressure reading using an inflatable cuff, just as your blood pressure is measured during a typical doctor’s appointment. […] Treatment for secondary hypertension involves treating the underlying medical condition with medications or surgery. Once the underlying condition is treated, your blood pressure might decrease or return to normal.
- #50 High Blood Pressure – Heart and Blood Vessel Disorders – Merck Manual Consumer Versionhttps://www.merckmanuals.com/home/heart-and-blood-vessel-disorders/high-blood-pressure/high-blood-pressure
With longstanding high blood pressure, the heart enlarges and the heart’s walls thicken because the heart has to work harder to pump blood. […] These changes in the heart may result in abnormal heart rhythms or heart failure. […] High blood pressure causes thickening of the walls of blood vessels and also makes them more likely to develop hardening of the arteries (atherosclerosis). […] Severe high blood pressure can cause the brain to swell, resulting in nausea, vomiting, worsening headache, drowsiness, confusion, seizures, sleepiness, and even coma. […] If high blood pressure is due to a pheochromocytoma (a rare tumor in the adrenal glands), symptoms may include severe headache, anxiety, an awareness of a rapid or irregular heart rate (palpitations), excessive perspiration, tremor, and paleness.
- #51 Secondary hypertension | Beacon Health Systemhttps://www.beaconhealthsystem.org/library/diseases-and-conditions/secondary-hypertension?content_id=CON-20155139
Secondary hypertension usually has no specific symptoms, even if blood pressure has reached dangerously high levels. […] For people diagnosed with high blood pressure, having any of these signs may mean the condition is secondary hypertension: High blood pressure that doesn’t respond to blood pressure medications (resistant hypertension), very high blood pressure systolic blood pressure over 180 millimeters of mercury (mm Hg) or diastolic blood pressure over 120 mm Hg, high blood pressure that no longer responds to medication that previously controlled the blood pressure, sudden-onset high blood pressure before age 30 or after age 55, no family history of high blood pressure, no obesity. […] Secondary hypertension can worsen the underlying medical condition that’s causing the high blood pressure. Without treatment, secondary hypertension can lead to other health problems, such as damage to arteries, aneurysm, heart failure, weakened and narrowed blood vessels in the kidneys, thickened, narrowed or torn blood vessels in the eyes, metabolic syndrome, trouble with memory or understanding.
- #52 Diagnosis of Secondary Hypertension: An Age-Based Approach | AAFPhttps://www.aafp.org/pubs/afp/issues/2010/1215/p1471.html
Hypothyroidism can cause an elevation in diastolic blood pressure, whereas hyperthyroidism can cause an isolated elevation of systolic blood pressure, leading to a widened pulse pressure. […] Primary aldosteronism, also referred to as hyperaldosteronism, is actually a group of conditions, including aldosterone-producing adenomas and bilateral idiopathic hyperaldosteronism. […] Obstructive sleep apnea is a notable cause of secondary hypertension, particularly in 40- to 59-year-olds, but less so in those 60 years and older. […] Pheochromocytomas are rare tumors responsible for approximately 0.5 percent of cases of secondary hypertension. […] Renal artery stenosis secondary to atherosclerotic disease affects older adults. […] Hypertension can be a major cause of renal parenchymal damage, particularly in older adults, which in turn leads to worsening hypertension.
- #53 Secondary hypertension – Symptoms & causes – Mayo Clinichttps://www.mayoclinic.org/diseases-conditions/secondary-hypertension/symptoms-causes/syc-20350679
No family history of high blood pressure […] No obesity. […] Secondary hypertension can worsen the underlying medical condition that’s causing the high blood pressure. Without treatment, secondary hypertension can lead to other health problems, such as: Damage to arteries. […] Heart failure. […] Trouble with memory or understanding. Uncontrolled high blood pressure also may affect the ability to think, remember and learn. Trouble with memory or understanding concepts is more common in people who have high blood pressure.
- #54 Secondary Hypertension | Southern Kidney Specialistshttps://southernkidney.com/secondary-hypertension/
There arent usually any symptoms associated with secondary hypertension. […] For some people struggling with blood pressure that has reached dangerously high levels, nose bleeds, headaches, or shortness of breath may appear. […] The following signs may indicate that your high blood pressure is secondary to another medical problem: Medication-resistant hypertension, Very high blood pressure, High blood pressure without obesity, Hypertension without a family history of high blood pressure, Sudden onset of high blood pressure after 55 or before age 30. […] You may also have high blood pressure previously controlled by medication that no longer responds to the medicine. […] When left untreated, secondary hypertension can worsen its underlying medical problem. It can cause an aneurysm, artery damage, heart failure, narrowed or weak kidney blood vessels, damage to the blood vessels in your eyes, and metabolic syndrome. You might also have memory problems or other cognitive issues.
- #55 High Blood Pressure – Heart and Blood Vessel Disorders – Merck Manual Consumer Versionhttps://www.merckmanuals.com/home/heart-and-blood-vessel-disorders/high-blood-pressure/high-blood-pressure
With longstanding high blood pressure, the heart enlarges and the heart’s walls thicken because the heart has to work harder to pump blood. […] These changes in the heart may result in abnormal heart rhythms or heart failure. […] High blood pressure causes thickening of the walls of blood vessels and also makes them more likely to develop hardening of the arteries (atherosclerosis). […] Severe high blood pressure can cause the brain to swell, resulting in nausea, vomiting, worsening headache, drowsiness, confusion, seizures, sleepiness, and even coma. […] If high blood pressure is due to a pheochromocytoma (a rare tumor in the adrenal glands), symptoms may include severe headache, anxiety, an awareness of a rapid or irregular heart rate (palpitations), excessive perspiration, tremor, and paleness.
- #56 Secondary hypertension | Beacon Health Systemhttps://www.beaconhealthsystem.org/library/diseases-and-conditions/secondary-hypertension?content_id=CON-20155139
Secondary hypertension usually has no specific symptoms, even if blood pressure has reached dangerously high levels. […] For people diagnosed with high blood pressure, having any of these signs may mean the condition is secondary hypertension: High blood pressure that doesn’t respond to blood pressure medications (resistant hypertension), very high blood pressure systolic blood pressure over 180 millimeters of mercury (mm Hg) or diastolic blood pressure over 120 mm Hg, high blood pressure that no longer responds to medication that previously controlled the blood pressure, sudden-onset high blood pressure before age 30 or after age 55, no family history of high blood pressure, no obesity. […] Secondary hypertension can worsen the underlying medical condition that’s causing the high blood pressure. Without treatment, secondary hypertension can lead to other health problems, such as damage to arteries, aneurysm, heart failure, weakened and narrowed blood vessels in the kidneys, thickened, narrowed or torn blood vessels in the eyes, metabolic syndrome, trouble with memory or understanding.
- #57 Secondary hypertension | Beacon Health Systemhttps://www.beaconhealthsystem.org/library/diseases-and-conditions/secondary-hypertension?content_id=CON-20155139
Secondary hypertension usually has no specific symptoms, even if blood pressure has reached dangerously high levels. […] For people diagnosed with high blood pressure, having any of these signs may mean the condition is secondary hypertension: High blood pressure that doesn’t respond to blood pressure medications (resistant hypertension), very high blood pressure systolic blood pressure over 180 millimeters of mercury (mm Hg) or diastolic blood pressure over 120 mm Hg, high blood pressure that no longer responds to medication that previously controlled the blood pressure, sudden-onset high blood pressure before age 30 or after age 55, no family history of high blood pressure, no obesity. […] Secondary hypertension can worsen the underlying medical condition that’s causing the high blood pressure. Without treatment, secondary hypertension can lead to other health problems, such as damage to arteries, aneurysm, heart failure, weakened and narrowed blood vessels in the kidneys, thickened, narrowed or torn blood vessels in the eyes, metabolic syndrome, trouble with memory or understanding.
- #58 Secondary Hypertension: Causes & Symptomshttps://my.clevelandclinic.org/health/diseases/21128-secondary-hypertension
Secondary hypertension itself usually doesn’t have symptoms (unless your blood pressure is very high). But you may develop symptoms from the underlying condition that’s causing it. […] Your healthcare provider may suspect secondary hypertension if: […] Another red flag is high blood pressure that starts before puberty. If this happens to your child, their pediatrician may look for secondary causes. […] Untreated, secondary hypertension can lead to hypertensive heart disease. This is damage to your heart that results from years of high blood pressure. You may also develop complications from the condition that’s raising your blood pressure. […] Secondary hypertension has a positive outlook with treatment. Early detection and treatment can lower the risk of damage to your blood vessels and heart from ongoing high blood pressure.
- #59 Secondary Hypertension – StatPearls – NCBI Bookshelfhttps://www.ncbi.nlm.nih.gov/sites/books/NBK544305/
Secondary hypertension is defined as elevated blood pressure (BP) secondary to an identifiable cause. […] The common clinical signs which warrant investigations for a secondary cause of hypertension may include; Resistant hypertension, i.e., persistent blood pressure greater than 140/90 mm Hg despite using optimal doses of at least three anti-hypertensive from different classes, that includes a diuretic. […] Development of hypertension in extremes of age accelerated end-organ dysfunction due to hypertension, resistant hypertension, and sudden rise in blood pressure in hypertensive individuals, who are stable on drug therapy, are classical features of secondary hypertension. […] Secondary hypertension is usually resistant to antihypertensive drugs if the underlying mechanism is not identified and treated appropriately. It may present with early end-organ dysfunction, hypertension crisis, and cardiovascular events at a younger age. […] However, with early identification and treatment of the underlying cause, secondary hypertension has a favorable prognosis.
- #60 Secondary Hypertension – Harvard Healthhttps://www.health.harvard.edu/a_to_z/secondary-hypertension-a-to-z
Most often doctors start to consider secondary hypertension when blood pressure is not controlled with two or three different medications or if the person has symptoms related to the underlying condition. […] For example, a tumor of the adrenal gland called a pheochromocytoma can cause sweating, palpitations, severe anxiety and weight loss. In Cushing’s syndrome, there may be weight gain, weakness, abnormal growth of body hair and loss of menstrual periods in women, and the appearance of purple „stretch marks” on the abdomen (abdominal striae). Hyperparathyroidism with elevated calcium levels can cause fatigue, increased urination, constipation and kidney stones. Hyperaldosteronism often causes weakness related to low blood potassium levels. […] Secondary hypertension will last as long as the medical problem that is causing it remains untreated. […] In many patients with secondary hypertension, high blood pressure can be cured when their underlying medical illness is treated successfully.
- #61 Secondary hypertension Guide: Causes, Symptoms and Treatment Optionshttps://www.drugs.com/health-guide/secondary-hypertension.html
Most often doctors start to consider secondary hypertension when blood pressure is not controlled with two or three different medications or if the person has symptoms related to the underlying condition. […] For example, a tumor of the adrenal gland called a pheochromocytoma can cause sweating, palpitations, severe anxiety and weight loss. In Cushing’s syndrome, there may be weight gain, weakness, abnormal growth of body hair and loss of menstrual periods in women, and the appearance of purple „stretch marks” on the abdomen (abdominal striae). Hyperparathyroidism with elevated calcium levels can cause fatigue, increased urination, constipation and kidney stones. Hyperaldosteronism often causes weakness related to low blood potassium levels. […] Inform you doctor if you have any of the symptoms associated with medical illnesses that cause secondary hypertension, such as unexplained weight change, palpitations, leg swelling (edema), marked fatigue, abnormal hair growth or new purplish stretch marks on your skin. […] In many patients with secondary hypertension, high blood pressure can be cured when their underlying medical illness is treated successfully.
- #62 Secondary Hypertension – StatPearls – NCBI Bookshelfhttps://www.ncbi.nlm.nih.gov/sites/books/NBK544305/
Secondary hypertension is defined as elevated blood pressure (BP) secondary to an identifiable cause. […] The common clinical signs which warrant investigations for a secondary cause of hypertension may include; Resistant hypertension, i.e., persistent blood pressure greater than 140/90 mm Hg despite using optimal doses of at least three anti-hypertensive from different classes, that includes a diuretic. […] Development of hypertension in extremes of age accelerated end-organ dysfunction due to hypertension, resistant hypertension, and sudden rise in blood pressure in hypertensive individuals, who are stable on drug therapy, are classical features of secondary hypertension. […] Secondary hypertension is usually resistant to antihypertensive drugs if the underlying mechanism is not identified and treated appropriately. It may present with early end-organ dysfunction, hypertension crisis, and cardiovascular events at a younger age. […] However, with early identification and treatment of the underlying cause, secondary hypertension has a favorable prognosis.
- #63 Secondary Hypertension – StatPearls – NCBI Bookshelfhttps://www.ncbi.nlm.nih.gov/sites/books/NBK544305/
Secondary hypertension is defined as elevated blood pressure (BP) secondary to an identifiable cause. […] The common clinical signs which warrant investigations for a secondary cause of hypertension may include; Resistant hypertension, i.e., persistent blood pressure greater than 140/90 mm Hg despite using optimal doses of at least three anti-hypertensive from different classes, that includes a diuretic. […] Development of hypertension in extremes of age accelerated end-organ dysfunction due to hypertension, resistant hypertension, and sudden rise in blood pressure in hypertensive individuals, who are stable on drug therapy, are classical features of secondary hypertension. […] Secondary hypertension is usually resistant to antihypertensive drugs if the underlying mechanism is not identified and treated appropriately. It may present with early end-organ dysfunction, hypertension crisis, and cardiovascular events at a younger age. […] However, with early identification and treatment of the underlying cause, secondary hypertension has a favorable prognosis.
- #64 Approach to the diagnosis of secondary hypertension in adultshttps://australianprescriber.tg.org.au/articles/approach-to-the-diagnosis-of-secondary-hypertension-in-adults.html
Presentations that should raise suspicion of secondary hypertension include early-onset, severe or resistant hypertension. […] The most common causes and associations are renal disease, primary aldosteronism and obstructive sleep apnoea. […] Secondary hypertension occurs in approximately 10% of adults with hypertension. […] Identifying secondary hypertension presents an opportunity to modify a patients cardiovascular risk profile beyond what is achievable by antihypertensive therapy alone. […] Patients with primary aldosteronism have a higher risk of cardiovascular morbidity and mortality than other age-, sex- and blood pressure-matched patients. […] Hypertension is often the only sign of primary aldosteronism. Most patients do not present with the classical feature of hypokalaemia.
- #65 Secondary Hypertension Causes, Symptoms, and Treatmentshttps://www.upmc.com/services/kidney-disease/conditions/hypertension
Your doctor may suspect secondary hypertension if you have high blood pressure that: […] Severe high blood pressure can cause: […] In some cases, secondary hypertension may go away if the underlying cause is successfully treated. […] If you experience severe symptoms of high blood pressure, call 911 or go to the nearest hospital emergency department. […] Your secondary hypertension prognosis depends on the cause and severity of your condition, as well as your overall health. […] Most people who have secondary hypertension also need to take one or more drugs to control their high blood pressure. […] Renal denervation is a highly successful procedure for secondary hypertension. Most people see a drop in their blood pressure numbers and can reduce their blood pressure medications. Some people may be able to stop taking blood pressure medications completely.
- #66 Ruling out secondary causes of hypertension | EuroInterventionhttps://eurointervention.pcronline.com/article/ruling-out-secondary-causes-of-hypertension
The prevalence of primary aldosteronism (PA) is greater than previously thought. […] Among untreated patients, the prevalence of PA increases in parallel with the increasing severity of the hypertension, from 2% in patients with stage 1 hypertension to 8% in those with stage 2 hypertension and 13% in those with stage 3 hypertension. […] OSA is a strong and independent risk factor for the presence of hypertension and cardiovascular diseases. […] Approximately 30% of adults with hypertension have OSA. […] Drug-induced hypertension is one of the most common causes of secondary hypertension and is often found in clinical practice. […] The use of non-steroidal anti-inflammatory drugs (NSAIDs) for example is often the cause of drug-induced hypertension. […] Although the prevalence of pheochromocytoma in the general hypertensive population is very low, diagnosis and treatment are extremely important in view of the possibility of precipitating hypertensive crisis if the tumour is stimulated. […] Hypertension is one of the most distinguishing features of endogenous Cushings syndrome, and can be found in about 80% of adult patients.
- #67 Secondary Hypertension: Causes & Symptomshttps://my.clevelandclinic.org/health/diseases/21128-secondary-hypertension
Secondary hypertension itself usually doesn’t have symptoms (unless your blood pressure is very high). But you may develop symptoms from the underlying condition that’s causing it. […] Your healthcare provider may suspect secondary hypertension if: […] Another red flag is high blood pressure that starts before puberty. If this happens to your child, their pediatrician may look for secondary causes. […] Untreated, secondary hypertension can lead to hypertensive heart disease. This is damage to your heart that results from years of high blood pressure. You may also develop complications from the condition that’s raising your blood pressure. […] Secondary hypertension has a positive outlook with treatment. Early detection and treatment can lower the risk of damage to your blood vessels and heart from ongoing high blood pressure.