Secondary hypertension

Secondary hypertension is high blood pressure caused by another condition or disease. Conditions that may cause secondary hypertension include kidney disease, adrenal disease, thyroid problems and obstructive sleep apnea.

In many patients with secondary hypertension, high blood pressure can be cured when their underlying medical illness is treated successfully.

Secondary high blood pressure (secondary hypertension) is high blood pressure that’s caused by another medical condition. Secondary hypertension can be caused by conditions that affect your kidneys, arteries, heart or endocrine system. Secondary hypertension can also occur during pregnancy.

Secondary hypertension differs from the usual type of high blood pressure (primary hypertension or essential hypertension), which is often referred to simply as high blood pressure.

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.

Causes of Secondary Hypertension:

• Chronic kidney disease.
• Sleep apnea.
• Tumors or other diseases of the adrenal gland.
• Coarctation of the aorta — A narrowing of the aorta that you are born with that can cause high blood pressure in the arms.
• Pregnancy.
• Use of birth control pills.
• Alcohol addiction.
• Thyroid dysfunction.

Symptoms: Symptoms of secondary hypertension can vary depending on the type of condition or disease that is acting in combination with high blood pressure. Additionally, there may be difficulty controlling high blood pressure by using just one or two medications. The American Heart Association guidelines now define high blood pressure as blood pressure reading 130/80 or higher.

• Examples of symptoms for some conditions can include:
• Pheochromocytoma: Sweating, increased frequency or force of heartbeats, headache, anxiety.
• Cushing’s syndrome: Weight gain, weakness, abnormal growth of body hair or loss of menstrual periods (in women), purple striations (lines) on the skin of the abdomen.
• Thyroid problems: Fatigue (tiredness), weight gain or weight loss, intolerance to heat or cold.
• Conn’s syndrome or primary aldosteronism: Weakness due to low levels of potassium in the body.
• Obstructive sleep apnea: excessive fatigue or sleepiness during daytime, snoring, pauses in breathing during sleep. Treatment : 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.You may need to continue to take blood pressure medication as well, and any underlying medical condition you have may affect your doctor’s choice of medication.Possible drug choices include:
• Thiazide diuretics. Diuretics, sometimes called water pills, are medications that help your kidneys eliminate sodium and water. Thiazide diuretics are often the first — but not the only — choice in high blood pressure medications.
• Diuretics are often generic and tend to be less expensive than other high blood pressure medications. If you’re not taking a diuretic and your blood pressure remains high, talk to your doctor about adding one or replacing a drug you currently take with a diuretic. Possible side effects of diuretics include weakness, leg cramps and a higher risk of sexual dysfunction.
• Beta blockers. These medications reduce the workload on your heart and open your blood vessels, causing your heart to beat slower and with less force. When prescribed alone, beta blockers don’t work as well in Black people — but they’re effective when combined with a thiazide diuretic.
• Possible side effects include fatigue, sleep problems, a slowed heart rate, and cold hands and feet. In addition, beta blockers generally aren’t prescribed for people with asthma, as they can increase muscle spasms in the lungs.
• Angiotensin-converting enzyme (ACE) inhibitors. These medications help relax blood vessels by blocking the formation of a natural chemical that narrows blood vessels. ACE inhibitors may be especially important in treating high blood pressure in people with coronary artery disease, heart failure or kidney failure.
• Like beta blockers, ACE inhibitors don’t work as well in Black people when prescribed alone, but they’re effective when combined with a thiazide diuretic. Possible side effects include dizziness and coughing. ACE inhibitors should not be taken during pregnancy.
• Angiotensin II receptor blockers. These medications help relax blood vessels by blocking the action — not the formation — of a natural chemical that narrows blood vessels. Like ACE inhibitors, angiotensin II receptor blockers often are useful for people with coronary artery disease, heart failure or kidney failure.These medications have fewer potential side effects than do ACE inhibitors. Angiotensin II receptor blockers should not be used during pregnancy.
• Calcium channel blockers. These medications help relax the muscles of your blood vessels or slow your heart rate. Calcium channel blockers may work better for some people than ACE inhibitors or beta blockers alone. Possible side effects include water retention, dizziness and constipation.
• Grapefruit juice interacts with some calcium channel blockers, increasing levels of the medication in your blood and putting you at a higher risk of side effects. Ask your doctor or pharmacist if your medication is affected by grapefruit juice.
• Direct renin inhibitors. These medications relax and widen the arteries by prevention the action of a protein (enzyme) called renin. Renin is released by your kidneys and helps control blood pressure. An example of a direct renin inhibitor is as aliskiren (Tekturna).
• Common side effects of aliskiren include dizziness and diarrhea. If you have diabetes or moderate to severe kidney problems, you shouldn’t use aliskiren in combination with ACE inhibitors or angiotensin II receptor blockers.
• Treatment for secondary hypertension can sometimes be complicated. You may need more than one medication combined with lifestyle changes to control your high blood pressure. Your doctor will want to see you more frequently — possibly as often as once a month — until your blood pressure is controlled. Your doctor may also recommend that you keep track of your blood pressure at home.