What is secondary hypertension?

The term secondary hypertension refers to high blood pressure, or hypertension, caused by underlying kidney, heart, or endocrine conditions. It can also develop during pregnancy.

There are multiple conditions that can trigger its development, such as:

• Aldosteronism
• Sleep apnea
• High cholesterol
• Thyroid conditions
• Polycystic kidney disease
• Glomerular disease
• Aortic narrowing
• Pheochromocytoma
• Hyperparathyroidism
• Renovascular hypertension
• Medications and supplements
• Diabetic nephropathy
• Obesity
• Cushing’s syndrome

Primary vs. Secondary Hypertension

Secondary hypertension has an identifiable and treatable cause, unlike primary or essential hypertension, which has no clear origin and usually develops gradually.

In secondary hypertension, the increase in blood pressure is a consequence of other conditions. It accounts for a smaller percentage of hypertension cases, but it is crucial to detect it because by treating the underlying cause, blood pressure can return to normal or improve significantly.

In the context of secondary hypertension, timely diagnosis is crucial, as in many cases it affects young people, presents with very high blood pressure values, or does not respond well to conventional treatments. Therefore, it is important to recognize the warning signs.

The symptoms of secondary hypertension can be more noticeable or unusual than those of primary hypertension, especially since they are often related to the underlying disease causing it.

For example, when the cause is a hormonal disorder, the patient may experience excessive sweating, palpitations, anxiety, or tremors. For patients with kidney disease, they may develop swelling in the legs, fatigue, or changes in urine.

It’s also possible for secondary hypertension to appear suddenly in young people or in those who previously had normal blood pressure levels.

Other symptoms that may occur are intense headaches, visual disturbances, or ringing in the ears when pressure rises abruptly.

The diagnosis of secondary hypertension begins with clinical suspicion, especially if there are certain signs such as a sudden and very high blood pressure, if it occurs in people under 30 without a family history, or a poor response to conventional hypertension treatments. It is also important to consider the use of certain substances or medications that can raise blood pressure.

When suspicion has been established, more specific studies are conducted, which will vary depending on the possible cause.

Hormonal tests may be requested if endocrine disorders such as pheochromocytoma or hyperaldosteronism are suspected; a renal ultrasound or angio-MRI if problems in the renal arteries are being sought; and sleep studies if obstructive apnea is suspected, to name a few examples.

The treatment for secondary hypertension is based on addressing and correcting the underlying cause that is leading to the increase in blood pressure.

Unlike primary hypertension, in secondary hypertension, the specific treatment for the underlying condition can often achieve a total or partial reversal of the hypertension.

Beyond the treatment aimed at the cause, it usually requires the use of antihypertensive medications to control blood pressure levels, at least until the underlying problem is stabilized or resolved. Throughout this process, it is important to monitor blood pressure.

Lifestyle changes are also often necessary, including reducing salt intake, maintaining a healthy weight, avoiding smoking, and getting regular physical activity.

At the Cardiovascular Center at ABC Medical Center, we can provide you with specialized care. Contact us!