Materiały źródłowe

• #1 Secondary Arterial Hypertension: When, Who, and How to Screen?

  https://www.acc.org/latest-in-cardiology/journal-scans/2014/01/10/15/45/secondary-arterial-hypertension-when-who-and-how-to-screen

  The following are 10 points to remember from a clinical update on secondary arterial hypertension: 1. Secondary hypertension (defined as hypertension due to an identifiable cause) affects only 5-10% of hypertensive patients. […] 3. Before screening for secondary arterial hypertension, pseudo-hypertension (defined as cuff diastolic BP at least 15 mm Hg higher than simultaneously measured intra-arterial BP) and pseudo-resistance (due to inadequate measurement techniques, as with too small cuff size) need to be excluded. […] 4. ABPM is the best measurement method to assess arterial BP, and allows for exclusion of white-coat hypertension, assessment of treatment adherence, confirmation of resistant hypertension, and assessment of dipping status. […] 5. The absence of a night-time drop in BP (dipping) of 10% relative to the daytime value during ABPM is associated with several secondary forms of hypertension.

• #2 Secondary Hypertension | Southern Kidney Specialists

  https://southernkidney.com/secondary-hypertension/

  Early detection and effective treatment of secondary hypertension reduce your chance of kidney failure, stroke, heart disease, and other problematic complications. […] Adopting healthy habits and properly managing chronic diseases are the best ways to reduce your risk of developing secondary hypertension. […] Its also important to adopt healthy lifestyle habits, including eating nutritious foods, minimizing your sodium intake, getting regular exercise, and maintaining an ideal body weight. Limit or avoid alcohol, dont smoke, and keep stress levels as low as possible.

• #3 Practice Recommendations for Diagnosis and Treatment of the Most Common Forms of Secondary Hypertension | High Blood Pressure & Cardiovascular Prevention

  https://link.springer.com/article/10.1007/s40292-020-00415-9

  The vast majority of hypertensive patients are never sought for a cause of their high blood pressure, i.e. for a ‘secondary’ form of arterial hypertension. […] The early detection of a secondary form is crucial, because if diagnosed in a timely manner, these forms can be cured at long-term, and even when cure cannot be achieved, their diagnosis provides a better control of high blood pressure, and allows prevention of hypertension-mediated organ damage, and related cardiovascular complications. […] The European Societies of Cardiology and Hypertension (ESC/ESH) guidelines suggest that the screening for SH should be restricted to patients with certain features, such as younger age (i.e. < 40 years), acute worsening of HT in patients with previously documented chronically stable normotension, severe (grade 3) or drug-resistant HT, presence of extensive hypertension-mediated organ damage (HMOD).

• #4 Prevention and Control of Hypertension: JACC Health Promotion Series

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6481176/

  Hypertension, the leading risk factor for cardiovascular disease, originates from combined genetic, environmental, and social determinants. Prevention and control of hypertension can be achieved through targeted and/or population-based strategies. […] The targeted approach is the traditional strategy used in health care practice and seeks to achieve a clinically important reduction in BP for individuals at the upper end of the BP distribution. The targeted approach is used in the management of patients with hypertension, but the same approach is well-proven as an effective strategy for prevention of hypertension in those at high risk of developing hypertension. […] The population-based strategy is derived from public health mass environmental control experience. It aims to achieve a smaller reduction in BP that is applied to the entire population, resulting in a small downward shift in the entire BP distribution.

• #5 Prevention and Control of Hypertension: JACC Health Promotion Series

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6481176/

  An appeal of the population-based approach is that modeling studies have consistently suggested that it provides greater potential to prevent CVD compared with the targeted strategy. […] For example, a general population DBP-lowering of as little as 2 mm Hg would be expected to result in a 17% reduction in the incidence of hypertension, a 14% reduction in stroke risk, and a 6% reduction in the risk of coronary heart disease. […] The Chronic Care Model, a collaborative partnership among the patient, provider, and health system, incorporates a multilevel approach for control of hypertension. Optimizing the prevention, recognition, and care of hypertension requires a paradigm shift to team-based care and the use of strategies known to control BP.

• #6 Diagnosis of Secondary Hypertension: An Age-Based Approach | AAFP

  https://www.aafp.org/pubs/afp/issues/2010/1215/p1471.html

  Secondary hypertension is a type of hypertension with an underlying, potentially correctable cause. […] Secondary hypertension also should be considered in patients with resistant hypertension, and early or late onset of hypertension. […] Whenever a patient is diagnosed with hypertension, one purpose of the initial assessment (i.e., history, physical examination, and basic laboratory testing) is to exclude possible secondary causes. […] 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.

• #7 Secondary Hypertension: Discovering the Underlying Cause | AAFP

  https://www.aafp.org/pubs/afp/issues/2017/1001/p453.html

  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. […] In the absence of clinical signs to suggest possible secondary hypertension in adults, indications for further evaluation include resistant hypertension and early, late, or rapid onset of high blood pressure. […] Preadolescent children with hypertension should be evaluated for possible secondary causes. […] Young adults thought to have secondary hypertension should be assessed for fibromuscular dysplasia of the renal artery with magnetic resonance angiography or computed tomography angiography.

• #8 Secondary Hypertension: Discovering the Underlying Cause | AAFP

  https://www.aafp.org/pubs/afp/issues/2017/1001/p453.html

  The aldosterone-to-renin ratio is the best initial test to determine whether a patient with hypertension should have further evaluation for hyperaldosteronism. […] Patients who are obese and who have signs or symptoms of obstructive sleep apnea and hypertension should be assessed with polysomnography. […] Treatment of OSA may improve blood pressure control, sleep quality, daytime sleepiness, and mortality.

• #9 Ruling out secondary causes of hypertension | EuroIntervention

  https://eurointervention.pcronline.com/article/ruling-out-secondary-causes-of-hypertension

  In the majority of hypertensive patients, no particular cause for abnormal blood pressure is evident (primary or essential hypertension). […] Consequently, screening for secondary causes of hypertension plays an essential part in the care of patients with arterial hypertension. […] If the basal work-up raises the suspicion of a secondary cause of hypertension, specific diagnostic procedures become necessary, some of which can be performed by primary care physicians, while others require specialist input. […] The prevalence of primary aldosteronism (PA) is greater than previously thought. […] If biochemical evidence for hyperaldosteronism can be confirmed, then the next step is imaging of the adrenal glands, i.e., by computed tomography. […] OSA is a strong and independent risk factor for the presence of hypertension and cardiovascular diseases.

• #10 Improved identification of secondary hypertension: use of a systematic protocol

  https://atm.amegroups.org/article/view/20388/html

  Utilizing the methods developed in the Center, this approach, known as the CHIC Protocol, could constitute a valuable tool for early recognition and accurate diagnosis of SH in clinical practice. […] Based on these results, we propose that our approach, originally developed for the unique diagnostic evaluation for physicians at the Institute of Cardiology, may represent a methodology that would facilitate the identification of SH in a variety of clinical sites. […] We suggest that using a systematic, standardized protocol as described herein, justifies an approach that does not abandon the search for SH in all patients. […] The CHIC Protocol may represent an opportunity to increase recognition of SH through anamnesis (or a detailed account of a patients medical history) and physical examination in all hypertensive patients. […] Therefore, this approach can be a significant change of our diagnosis paradigm and could contribute to the appropriate recognition and diagnosis of SH in a wider range of patients with moderate and severe hypertension.

• #11 JMIR Medical Informatics – An Application of Machine Learning to Etiological Diagnosis of Secondary Hypertension: Retrospective Study Using Electronic Medical Records

  https://medinform.jmir.org/2021/1/e19739/

  Application of ML methods to etiological diagnosis of secondary hypertension can be useful in clinical practice. […] The ML prediction models derived from our study hold promise for developing a diagnostic tool for detection of secondary hypertension and integration into EMR systems to offer real-time clinical support. […] Based on the EMRs from Fuwai Hospital, 5 ML prediction models with good performance and applicable to etiologies detection of secondary hypertension in all age groups of adults were developed, which demonstrated that ML approaches were feasible and effective in the diagnosis of secondary hypertension.

• #12 Secondary hypertension: What is secondary high blood pressure?

  https://www.medicalnewstoday.com/articles/secondary-hypertension

  Secondary hypertension is when a person has high blood pressure due to another condition, such as kidney disease. Treating the underlying condition may reverse it. […] It is not always possible to prevent secondary hypertension for instance, if it results from genetic factors or features a person is born with. […] However, lifestyle choices can help reduce the risk of some underlying conditions, such as kidney disease and atherosclerosis. These include avoiding a high-sodium diet and not smoking. […] For anyone with secondary hypertension, it is essential to follow both the treatment plan for any underlying conditions and a doctors recommendations on monitoring and managing secondary hypertension.

• #13 Chapter 13. Secondary hypertension | Hypertension Research

  https://www.nature.com/articles/hr201416

  Hypertension related to a specific etiology is termed secondary hypertension, markedly differing from essential hypertension, of which the etiology cannot be identified, in the condition and therapeutic strategies. […] Therefore, it is important to suspect secondary hypertension and reach an appropriate diagnosis. […] The possibility of secondary hypertension should be considered in the diagnosis and treatment of all hypertensive patients. It is important to conduct appropriate examinations without overlooking findings of secondary hypertension. […] As there is no radical treatment for CKD at present, blood pressure control by antihypertensive drug therapy primarily using RA system inhibitors (angiotensin II receptor blockers (ARBs) or angiotensin-converting enzyme (ACE) inhibitors) is extremely important for the prevention of end-stage renal failure.

• #14 Chapter 13. Secondary hypertension | Hypertension Research

  https://www.nature.com/articles/hr201416

  The incidence of PA is high. The disease can be cured, but often causes organ damage. Early diagnosis and treatment are therefore important. In hypertensive patients, especially in those at a high risk of PA, screening should be positively performed, and a definitive diagnosis should be made based on the results of confirmatory tests and localization diagnosis. […] Antihypertensive treatment for this disease is basically the same as that for renovascular or essential hypertension. However, as cerebral blood flow may be reduced in patients with stenotic lesions in the carotid artery, sufficient evaluation and attention for the cerebral blood flow is necessary for conducting antihypertensive treatment.

• #15 Ruling out secondary causes of hypertension | EuroIntervention

  https://eurointervention.pcronline.com/article/ruling-out-secondary-causes-of-hypertension

  Screening and diagnosing of OSA should be taken into account, since it was also shown that the higher the BP and/or more severe OSA, the larger the reduction. […] Drug-induced hypertension is one of the most common causes of secondary hypertension and is often found in clinical practice. […] The elimination of the responsible agent is not always possible in some cases, but a dose reduction or an alternative treatment option should be considered. […] Hence, from a clinical point of view specific underlying diseases, which should be ruled out in patients with treatment-resistant hypertension, are reported. […] Cushings syndrome should also be considered in patients with treatment-resistant hypertension and in patients with adrenal incidentaloma. […] Hypertensive adults with congenital heart disease should be screened for possible coarctation of the aorta.

• #16 Secondary Hypertension: Just as Essential as Primary | Brown Med-Peds

  https://brownmedpedsresidency.org/secondary-hypertension-just-as-essential-as-primary/

  „Importantly, medical therapy remains the cornerstone of treating RAS, regardless of cause.” […] „In the clinical assessment of hypertension, a careful history should be taken with regard to substances that may impair BP control, with close attention paid to not only prescription medications, but also over-the-counter substances, illicit drugs, and herbal products. When feasible, drugs associated with increased BP should be reduced or discontinued, and alternative agents should be used.”

• #17 Secondary hypertension – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/secondary-hypertension/diagnosis-treatment/drc-20350684

  Treatment for secondary hypertension involves treating the medical condition that’s causing it with medications or surgery. Once the condition is treated, blood pressure might decrease or return to normal. […] Healthy lifestyle changes are recommended to keep the heart healthy and blood pressure low. These include: […] Try the Dietary Approaches to Stop Hypertension (DASH) diet, which emphasizes fruits, vegetables, whole grains and low-fat dairy foods. Get plenty of potassium, which is found in fruits and vegetables such as potatoes, spinach, bananas and apricots, to help prevent and control high blood pressure. […] A lower sodium intake 1,500 milligrams (mg) a day is appropriate for people 51 years of age and older and for people of any age who are Black or who have hypertension, diabetes or chronic kidney disease.

• #18 Hypertension – Wikipedia

  https://en.wikipedia.org/wiki/Hypertension

  Effective lifestyle modification may lower blood pressure as much as an individual antihypertensive medication. Combinations of two or more lifestyle modifications can achieve even better results. […] There is considerable evidence that reducing dietary salt intake lowers blood pressure, but whether this translates into a reduction in mortality and cardiovascular disease remains uncertain.

• #19 Secondary hypertension – Augusta HealthSearchClose SearchSearch IconSearch IconClose Search IconMobile Menu IconMobile Menu Close IconInstagramFacebookTwitterYoutube

  https://www.augustahealth.com/disease/secondary-hypertension/

  Proper treatment of secondary hypertension can often control both the underlying condition and the high blood pressure, which reduces the risk of serious complications — including heart disease, kidney failure and stroke. […] 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. […] Healthy lifestyle changes are recommended to keep your heart healthy and your blood pressure low. These include: Eating healthy foods. Try the Dietary Approaches to Stop Hypertension (DASH) diet, which emphasizes fruits, vegetables, whole grains and low-fat dairy foods. […] Decreasing the salt in your diet. A lower sodium intake — 1,500 milligrams (mg) a day — is appropriate for people 51 years of age and older and for people of any age who are Black or who have hypertension, diabetes or chronic kidney disease.

• #20 High Blood Pressure: Symptoms & Causes

  https://my.clevelandclinic.org/health/diseases/4314-hypertension-high-blood-pressure

  Fortunately, there are things you can do to reduce your risk of developing high blood pressure. These include: […] Follow a healthy eating plan. This is an important step in keeping your blood pressure normal. The DASH diet (Dietary Approaches to Stop Hypertension) emphasizes adding fruits, vegetables and whole grains to your diet. […] Cut down on sodium. To prevent hypertension, you should reduce the amount of sodium in your diet. Try to keep it below 1,500 milligrams a day. […] Keep a healthy weight. Going hand-in-hand with a proper diet is keeping a weight that’s healthy for you. Losing excess weight with diet and exercise will help lower your blood pressure to healthier levels. […] Keep active. Even simple physical activities, such as walking, can lower your blood pressure (and your weight). […] Drink alcohol in moderation. Having more than one drink a day (for women) or more than two drinks a day (for men) can raise blood pressure. One drink is defined as 1 ounce (oz) of alcohol, 5 ounces of wine or 12 ounces of beer.

• #21 Secondary hypertension – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/secondary-hypertension/diagnosis-treatment/drc-20350684

  If you’re overweight, losing even 10 pounds (4.5 kilograms) can lower your blood pressure. […] Regular physical activity can help lower blood pressure and keep weight under control. Strive for at least 30 minutes of physical activity a day. […] If you choose to drink alcohol, do so in moderation. For healthy adults, that means up to one drink a day for women and two drinks a day for men. […] Tobacco injures blood vessel walls and speeds up the process of hardening of the arteries. If you smoke, ask your health care provider to help you quit. […] Reduce stress as much as possible. Practice healthy coping techniques, such as muscle relaxation and deep breathing. Getting plenty of sleep can help, too.

• #22 Secondary hypertension – Augusta HealthSearchClose SearchSearch IconSearch IconClose Search IconMobile Menu IconMobile Menu Close IconInstagramFacebookTwitterYoutube

  https://www.augustahealth.com/disease/secondary-hypertension/

  Maintaining a healthy weight. If you’re overweight, losing even 10 pounds (4.5 kilograms) can lower your blood pressure. […] Increasing physical activity. Regular physical activity can help lower your blood pressure and keep your weight under control. […] Limiting alcohol. Even if you’re healthy, alcohol can raise your blood pressure. […] Not smoking. Tobacco injures blood vessel walls and speeds up the process of hardening of the arteries. […] Managing stress. Reduce stress as much as possible. Practice healthy coping techniques, such as muscle relaxation and deep breathing. Getting plenty of sleep can help, too.

• #23 Shifting from Pharmacotherapy to Prevention of Hypertension

  https://www.e-jcpp.org/journal/view.php?viewtype=pubreader&number=25

  Therefore, current recommendations from the World Health Organisation and the American US Physical Activity Guidelines US Department of Health and Human Services (of exercising at least 150 minutes a week are highly appropriate. […] Lifestyle modification fits the bill very well. […] While detecting and adequately treating hypertension remain important goals in the management of hypertension, the prospect of preventing hypertension is very attractive.

• #24 Preventing High Blood Pressure | High Blood Pressure | CDC

  https://www.cdc.gov/high-blood-pressure/prevention/index.html

  Talk with your health care team about eating a variety of foods rich in potassium, fiber, and protein and lower in salt (sodium) and saturated fat. […] Talk with your health care team about ways to reach a healthy weight, including choosing healthy foods and getting regular physical activity. […] Talk with your health care team about ways to stop smoking or reducing how much alcohol you consume. […] For many people, making these healthy changes can help keep blood pressure low and protect against heart disease and stroke. […] Having overweight or obesity increases your risk for high blood pressure. […] Physical activity can help keep you at a healthy weight and lower your blood pressure. […] Smoking raises your blood pressure and puts you at higher risk for heart attack and stroke.

• #25 Preventing High Blood Pressure | High Blood Pressure | CDC

  https://www.cdc.gov/high-blood-pressure/prevention/index.html

  Do not drink too much alcohol, which can raise your blood pressure. […] Not getting enough sleep on a regular basis is linked to an increased risk of heart disease, high blood pressure, and stroke. […] People who have depression, anxiety, stress, or post-traumatic stress disorder over a long period of time may develop other health problems, including an increased heart rate and high blood pressure.

• #26 Secondary Arterial Hypertension: When, Who, and How to Screen?

  https://www.acc.org/latest-in-cardiology/journal-scans/2014/01/10/15/45/secondary-arterial-hypertension-when-who-and-how-to-screen

  The following are 10 points to remember from a clinical update on secondary arterial hypertension: 1. Secondary hypertension (defined as hypertension due to an identifiable cause) affects only 5-10% of hypertensive patients. […] 3. Before screening for secondary arterial hypertension, pseudo-hypertension (defined as cuff diastolic BP at least 15 mm Hg higher than simultaneously measured intra-arterial BP) and pseudo-resistance (due to inadequate measurement techniques, as with too small cuff size) need to be excluded. […] 4. ABPM is the best measurement method to assess arterial BP, and allows for exclusion of white-coat hypertension, assessment of treatment adherence, confirmation of resistant hypertension, and assessment of dipping status. […] 5. The absence of a night-time drop in BP (dipping) of 10% relative to the daytime value during ABPM is associated with several secondary forms of hypertension.

• #27 Hypertension -Symptoms & Prevention – PrognoHealth – Corporate Health & Wellness Specialist

  https://prognohealth.com/blog/mental-health/hypertension-symptoms-prevention/

  Here are 8 preventive tips to help individuals maintain healthy blood pressure levels and reduce the risk of hypertension-related complications: 1. Healthy Diet: Adopting a diet rich in fruits, vegetables, whole grains, lean proteins, and low-fat dairy products can help lower blood pressure. Limiting salt intake, avoiding processed foods, and reducing consumption of saturated and trans fats can further support blood pressure management. 2. Regular Physical Activity: Regular exercise, such as brisk walking, swimming, cycling, or aerobics, can help lower blood pressure and improve overall cardiovascular health. As health authorities recommend, aim for at least 150 minutes of moderate-intensity exercise or 75 minutes of vigorous exercise per week. 3. Maintain a Healthy Weight: Excess weight, particularly around the waistline, increases the risk of hypertension. Losing even a small amount of weight can significantly reduce blood pressure. Adopting a balanced diet and incorporating regular physical activity can help achieve and maintain a healthy weight. 4. Limit Alcohol Consumption: Excessive alcohol consumption can raise blood pressure and contribute to other health problems. Limit alcohol intake to moderate levelsup to one drink per day for women and up to two drinks per day for men, as defined by health guidelines. 5. Quit Smoking: Smoking can damage blood vessels and raise blood pressure. Quitting smoking can not only reduce blood pressure but also decrease the risk of heart disease, stroke, and other health complications. 6. Manage Stress: Chronic stress can contribute to hypertension. Practice stress-reduction techniques such as deep breathing, meditation, yoga, or spending time on hobbies and activities you enjoy. Prioritize relaxation and self-care to help manage stress levels effectively. 7. Monitor Blood Pressure Regularly: Regular monitoring of blood pressure at home can help track changes and detect any abnormalities early. Work with your healthcare provider to establish a monitoring schedule and discuss any concerns or fluctuations in blood pressure readings. 8. Follow Your Doctors Advice: If diagnosed with hypertension, follow your doctors recommendations regarding medication, lifestyle modifications, and regular check-ups. Adhering to prescribed treatment plans can help control blood pressure and reduce the risk of complications.

• #28

  https://healthmatch.io/high-blood-pressure/what-is-secondary-hypertension

  Secondary hypertension is high blood pressure caused by another underlying condition affecting your kidneys, heart, arteries, or endocrine system. […] 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. […] Early diagnosis of secondary hypertension and appropriate targeted treatment can potentially improve blood pressure. It can control or reduce the number of prescribed antihypertensive medications in some people or cure hypertension in others. […] Fortunately, since an underlying medical condition causes secondary hypertension, it is possible to treat. Early diagnosis is essential, so book an appointment with your healthcare provider if you suspect any conditions that cause secondary hypertension.

• #29 Secondary hypertension Guide: Causes, Symptoms and Treatment Options

  https://www.drugs.com/health-guide/secondary-hypertension.html

  Most of the medical problems that cause secondary hypertension can’t be prevented. This makes secondary hypertension different from primary hypertension, which can be prevented by exercising regularly, restricting salt, following a healthy diet, watching your weight and avoiding smoking. […] The treatment of secondary hypertension depends on its cause. When secondary hypertension results from a tumor or a blood vessel abnormality, surgery may be recommended. However, the decision to do surgery is often guided by the age and general health of the patient. For some patients, anti-hypertensive medications may be a safer option than surgery. […] In many patients with secondary hypertension, high blood pressure can be cured when their underlying medical illness is treated successfully.

• #30 Secondary Arterial Hypertension: When, Who, and How to Screen?

  https://www.acc.org/latest-in-cardiology/journal-scans/2014/01/10/15/45/secondary-arterial-hypertension-when-who-and-how-to-screen

  6. Obstructive sleep apnea is one of the most common causes of secondary hypertension. Nocturnal hypoxemia may impact the renin-angiotensin-aldosterone system and increase sympathetic nerve activity. […] 10. Even after identification and treatment of a secondary cause of hypertension, BP may not return to normal. This is likely secondary to concomitant essential hypertension and/or vascular remodeling that has occurred over time.

• #31 Secondary Hypertension Causes, Symptoms, and Treatments

  https://www.upmc.com/services/kidney-disease/conditions/hypertension

  You may be able to prevent secondary hypertension by maintaining a healthy weight and treating any health conditions that can increase your risk for the disease. […] To reduce your risk of secondary hypertension, you can: […] Control chronic conditions See a doctor for regular care if you have diabetes or obstructive sleep apnea. […] Eat a healthy diet with lots of fruits and vegetables. They’re high in potassium, which promotes healthy blood pressure. Limiting salt from shakers and processed foods also helps reduce your blood pressure. […] Exercise Aim for at least 30 minutes of moderate-intensity physical activity most days of the week. […] Get preventive care Check your blood pressure and blood sugar (glucose) routinely. […] Keep track of medications Inform your doctor if you routinely take over-the-counter drugs or herbal supplements and avoid or limit the use of NSAID medications (e.g., ibuprofen, naproxen). […] Manage stress Take steps to manage stress and get at least 7 to 8 hours of sleep each night. […] Reduce alcohol intake Limit alcohol to one drink a day for women and two drinks per day for men. […] Stop smoking Quit smoking if you smoke cigarettes or marijuana.

• #32 Secondary Hypertension – Harvard Health

  https://www.health.harvard.edu/a_to_z/secondary-hypertension-a-to-z

  Most of the medical problems that cause secondary hypertension can’t be prevented. This makes secondary hypertension different from primary hypertension, which can be prevented by exercising regularly, restricting salt, following a healthy diet, watching your weight and avoiding smoking. […] The treatment of secondary hypertension depends on its cause. When secondary hypertension results from a tumor or a blood vessel abnormality, surgery may be recommended. However, the decision to do surgery is often guided by the age and general health of the patient. For some patients, anti-hypertensive medications may be a safer option than surgery.

• #33 Shifting from Pharmacotherapy to Prevention of Hypertension

  https://e-jcpp.org/journal/view.php?doi=10.36011/cpp.2020.2.e8

  Hypertension is a common chronic disease affecting a large section of the general population. […] Therefore, prevention is better than cure. As blood pressure rises with age, prevention should be started early. […] Good antenatal care and care of preterm infants can help to prevent adult cardiovascular diseases including hypertension. […] Childhood obesity is an important determinant of blood pressure in childhood and adolescence. This is a window of opportunity for prevention. […] Cardiovascular risk assessment and promoting a healthy lifestyle in the young are likely to forestall hypertension and future cardiovascular disease. Preventing or reversing hypertension is no longer an impossible dream. […] Therefore, the prevention of hypertension should be started at an early age before it becomes full-blown. This is a window of opportunity for the prevention of hypertension.

• #34 Shifting from Pharmacotherapy to Prevention of Hypertension

  https://www.e-jcpp.org/journal/view.php?viewtype=pubreader&number=25

  Therefore, good antenatal care has a bearing on metabolic syndrome and hypertension in later life. […] As blood pressure rises with age, it means that the prevention of hypertension should be started at an early age before it becomes full-blown. This is a window of opportunity for the prevention of hypertension. […] The relationship between blood pressure and obesity should not come as a surprise since hypertension and obesity are both components of the metabolic syndrome. […] Combating childhood obesity should be high on the agenda because if unchecked, there will be in store for the future epidemics of not only hypertension, but also type 2 diabetes and coronary heart disease. […] Stage 1 hypertension should therefore be easy to control. Most of these patients do not require drug treatment.

• #35 Shifting from Pharmacotherapy to Prevention of Hypertension

  https://e-jcpp.org/journal/view.php?doi=10.36011/cpp.2020.2.e8

  Combating childhood obesity should be high on the agenda because if unchecked, there will be in store for the future epidemics of not only hypertension, but also type 2 diabetes and coronary heart disease. […] While detecting and adequately treating hypertension remain important goals in the management of hypertension, the prospect of preventing hypertension is very attractive.

• #36 Diagnosis of Secondary Hypertension: An Age-Based Approach | AAFP

  https://www.aafp.org/pubs/afp/issues/2010/1215/p1471.html

  In the absence of clinical signs to suggest possible secondary hypertension in adults, indications for further evaluation include resistant hypertension and early, late, or rapid onset of high blood pressure. […] All preadolescent children with hypertension should be evaluated for possible secondary causes. […] Young adults thought to have secondary hypertension should be assessed for fibromuscular dysplasia of the renal artery. […] The aldosterone/renin ratio is the best initial test to determine whether a patient with hypertension should have further evaluation for aldosteronism. […] Obstructive sleep apnea can be a secondary cause of or contribute to hypertension.

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