Secondary hypertension

Introduction Secondary hypertension refers to hypertension secondary to other diseases or causes. That is, hypertension with a clear cause. When the cause is detected and the cause is effectively removed or controlled, hypertension as a secondary symptom can be cured or significantly relieved. Secondary hypertension accounts for 5-10% of the hypertensive population. Endocrine, renovascular hypertension, and sleep apnea syndrome, as well as high blood pressure caused by mental and psychological problems are often seen. The risk of cardiovascular disease, stroke, proteinuria, and renal insufficiency is often higher in patients with secondary hypertension, and the cause is often overlooked to delay diagnosis.

Cause

Common causes of secondary hypertension are:

A. Kidney disease, such as acute and chronic glomerulonephritis, pyelonephritis, renal artery stenosis, etc.;

B. Macrovascular disease, such as macrovascular malformation (congenital aortic coarctation), multiple arteritis, etc.;

C. Pregnancy-induced hypertension syndrome, which occurs mostly in the third trimester of pregnancy and terminates the pregnancy in severe cases;

D. Endocrine diseases, such as pheochromocytoma, primary aldosteronism, etc.;

E. Brain disorders, such as brain tumors, brain trauma, etc.;

F. Drug-induced factors, such as long-term oral contraceptives, long-term application of hormones in organ transplantation.

an examination

Related inspection

Renal MRI examination blood routine kidney CT examination uric acid

24-hour urinary 17-hydroxyl and 17-ketosteroids, dexamethasone inhibition test and positive adrenal cortex stimulation test are helpful for diagnosis. Intracranial sellar X-ray, adrenal CT scan and radioactive iodinated cholesterol adrenal scan can be used for lesion localization. Aortic angiography can determine the diagnosis of aortic coarctation. High-dose tomography pyelography and radionuclide kidney map are helpful for diagnosis, and renal artery angiography can clearly diagnose renal artery stenosis. Determination of catecholamine and its metabolite vanillyl mandelic acid (VMA) in blood or urine during high blood pressure increases, if significantly increased, suggesting pheochromocytoma. Ultrasound, radionuclide and computed tomography (CT), magnetic resonance imaging showed the location of the tumor.

Differential diagnosis

According to the different causes and principles of hypertension, the medical profession divides hypertension into two categories: primary hypertension (ie, hypertension) and secondary hypertension (ie, symptomatic hypertension). Essential hypertension is a common and frequently-occurring disease. Some people account for more than 80% of all hypertension. It has its own unique etiology and developmental rules. It is essentially different from symptomatic hypertension. Secondary hypertension is relatively rare, accounting for about 10%-20% of high blood pressure. It refers to high blood pressure caused by certain diseases. Hypertension is only one of the symptoms of this disease. If the primary disease can be cured, then the symptoms of hypertension will naturally disappear. In clinical diagnosis, it is necessary to exclude secondary hypertension caused by various diseases in order to be diagnosed as essential hypertension.

The material in this site is intended to be of general informational use and is not intended to constitute medical advice, probable diagnosis, or recommended treatments.