Secondary arterial hypertension is the rarest type of hypertension. Secondary arterial hypertension is diagnosed in only 5% of patients. sick. Its causes can be determined - it is a disease with high blood pressure as one of the symptoms. What are the most common diseases causing secondary arterial hypertension? What are its symptoms? What is diagnosis and treatment?

Secondary hypertensionis a type of hypertension that can be traced back to you - it is a disease where high blood pressure may be one of the symptoms.

When a patient has symptoms of a disease that may cause secondary hypertension and high blood pressure values, secondary hypertension may be suspected. The causes of secondary hypertension are also sought when hypertension appears at a young age or suddenly in old age.

The diagnosis of secondary hypertension is important for two reasons. Firstly, it sometimes allows for the effective removal of the cause of hypertension and the secondary normalization of pressure without the need for long-term pharmacotherapy.

Second, you can be saved from other effects of a pressure-causing illness, such as kidney failure or a hypertensive crisis.

Contents:

  1. Secondary hypertension - causes
  2. Secondary vs primary hypertension
  3. Secondary hypertension - symptoms
  4. Secondary arterial hypertension - diagnosis
  5. Secondary hypertension - treatment

Secondary hypertension-causes

The most common causes of secondary hypertension are: parenchymal diseases (acute and chronic glomerulonephritis, diabetic nephropathy, kidney damage in systemic connective tissue diseases, renal cystic disease, hydronephrosis) and impaired blood flow in the renal artery or arteries (hypertension renal vascular), obstructive sleep apnea and primary hyperaldosteronism.

Common causes of secondary hypertensionRare causes of secondary hypertension
  • diseases of the kidney parenchyma
  • narrowing of the renal artery / arteries
  • obstructive sleep apnea
  • primary hyperaldosteronism (diseaseConna)
  • pregnancy
  • drugs and chemicals
- non-steroidal anti-inflammatory drugs - cyclosporine - oral contraceptives - glucocorticoids
  • hyperthyroidism
  • anemia
  • aortic regurgitation
  • arteriovenous fistulas
  • tumors that secrete renin
  • congenital adrenal hyperplasia
  • Cushing's syndrome
  • pheochromocytoma
  • hyperparathyroidism
  • acromegaly
  • aortic stenosis
  • porphyria
  • lead poisoning
  • Guillain-Barré syndrome
Worth knowing

Secondary vs primary hypertension

Primary arterial hypertension is a permanent increase in blood pressure for no apparent reason, of genetic or environmental background, and it accounts for approx. 95 percent. all cases of hypertension.

In other cases, when a potential cause of hypertension is found, secondary hypertension is diagnosed.

Secondary hypertension - symptoms

According to specialists from the Polish Society of Hypertension¹, parenchymal kidney disease is the most common cause of secondary hypertension.

Symptoms that may suggest kidney disease include:

  • swelling around the eyes, swelling of the hands, feet, ankles
  • burning and soreness when urinating
  • pollakiuria
  • urinating at night
  • dark, bloody urine
  • cloudy urine with a sharp smell reminiscent of ammonia
  • soreness below the ribs not getting worse with movement and increased blood pressure

Renovascular hypertension is the second most common cause of secondary hypertension, occurring in approximately 2% of respondents. adult patients with elevated blood pressure.

It is caused by one or more stenosis of the renal arteries in the extra-renal segment, which is often atherosclerotic in the elderly population.

Another common cause of secondary hypertension is obstructive sleep apnea. In addition to hypertension, patients develop headaches, pathological daytime sleepiness, difficulty concentrating, fatigue, personality disorders and depression.

Dangerous arrhythmias are often present. A very typical symptom of the sleep apnea syndrome is snoring with periods of apnea reported by relatives of the patient.

Secondary hypertension may suggest sudden onset, high baseline values, and resistance to treatmentpharmacological.

Primary aldosteronism is the excess secretion of a hormone called aldosterone. Excessive secretion of aldosterone, in addition to increasing blood pressure, causes fibrosis and hypertrophy of smooth muscles of the vessels and the heart, and has a pro-inflammatory and pro-thrombotic effect.

Hypertension in primary hyperaldosteronism is often severe, resistant to pharmacological treatment, and symptoms associated with long-term hypokalemia develop, such as muscle weakness, muscle spasms, paralysis, tetany, carbohydrate disorders, polyuria, increased thirst .

Important

Symptoms suggesting secondary nature of hypertension:

  • hypertension before the age of 20 or over 50
  • pressure greater than 180/110 mm Hg
  • sudden deterioration of previously well-controlled hypertension
  • drug-resistant hypertension
  • paroxysmal hypertension accompanied by: tachycardia, sweating, tremors
  • family history of kidney disease
  • symptoms of organ complications: advanced eye fundus changes, kidney failure, enlargement of the heart cavities, left ventricular hypertrophy

Secondary arterial hypertension - diagnosis

Certain symptoms may lead to the suspicion of secondary hypertension. Additional tests performed routinely are helpful in further diagnostics. The diagnosis of hypertension includes not only blood pressure measurement, but also blood, urine and imaging tests.

Secondary hypertension - treatment

The disease that causes hypertension should be treated. In addition, appropriately selected drugs for hypertension are used. It is also necessary to change the lifestyle (proper diet, incorporating physical activity, limiting alcohol, eliminating tobacco).

Source:

1. Screening detection and treatment of secondary forms of hypertension, nadcisnienietetnicze.pl/ukryte/zalecenia_esh_stare/wtorne_postacie_nadciseniem

Category:

Cardiology