The urgency in identifying and treating primary aldosteronism is heightened by data from studies showing that persistent elevations of aldosterone can result in endorgan damage. In contrast, secondary hypertension has a known cause. 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. Renal parenchymal hypertension, caused by renal parenchymal disorders, is a common form of secondary hypertension, accounting for 25% of. Most hypertension cannot be cured, only controlled. Secondary causes of resistant hypertension hypertension. The diagnosis of essential and secondary hypertension in. The most common forms of secondary hypertension are as follows. Over 95% of all cases of hypertension are in this category. Approximately 5% of adults with hypertension have a secondary cause.
Stefan reuter1, david maintz2, ludger feyen2, hermann pavenstadt1, michael kohler2 and eckhart bussemaker1,3. Secondary hypertension occurs in 510% of cases in the patient population with primary hypertension. Common secondary causes of resistant hypertension and. The abcde mnemonic can be used to help determine a secondary cause of hypertension. Consider the need for specialist investigations in people with signs and symptoms suggesting a secondary cause of hypertension. Evaluation of secondary causes of resistant hypertension. Secondary hypertension is the presence of a specific condition known to cause hypertension, which may be the primary cause or a contributing factor in a patient who already has primary hypertension.
It is much less common than the other type, called essential hypertension, affecting only 5% of hypertensive patients. See box 351 for factors that suggest the presence of secondary hypertension, and table 352 for etiologies and screening techniques. Failure to recognise secondary causes can lead to resistant hypertension, cardiovascular complications or complications of the underlying condition. Read on to find out what causes hypertension, its symptoms, types, and how to prevent it. Secondary hypertension in adults pubmed central pmc. A thorough medical history and physical examination can often give clues as. Because secondary hypertension is rare, occurring in only 5 to 10 percent of the population, it is not always discovered. Secondary hypertension is often resistant hypertension, for which a target blood pressure is difficult to achieve by standard treatment. The prevalence of secondary hypertension and the most common aetiologies vary by age group. Neurogenic hypertension is also caused by increases in intracranial pressure due to brain tumor or other causes, cerebrovascular disorders. Hypertension may be primary, which may develop as a result of environmental or genetic causes, or secondary, which has multiple etiologies, including renal, vascular, and endocrine causes. Seven hundred and ninetyeight men who had blood pressures above 175115 mm hg at preliminary screening were recalled for further blood pressure measurements.
However, a small percentage of people with this type of high blood pressure may be able to get rid of it. This material may not otherwise be downloaded, copied, printed, stored. The most common causes of secondary hypertension are various kidney diseases, such as renovascular disease, chronic glomerulonephritis, and chronic pyelonephritis often associated with reflux nephropathy. Secondary hypertension symptoms and causes mayo clinic. Three hundred and siztyone men were undergoing treatment for hypertension. About 10% of patients with hypertension have a secondary. Fewer than 10% of patients have secondary hypertension. Hypertension can be classified into secondary hypertension and essential hypertension. A rare cause of secondary hypertension kidney international.
Secondary hypertension due to primary hyperreninism jama. Pdf common secondary causes of resistant hypertension and. Learn more from webmd about the causes and treatment of secondary. Secondary hypertension is elevated blood pressure that results from an underlying. Secondary hypertension is a common cause of hypertension in adults, occurring in about 10% of hypertensive patients. Secondary hypertension occurs in a significant proportion of adult patients 10%. Although uncommon, it may cause major morbidity for a subset of patients. Diagnosing secondary hypertension american family physician.
Other underlying causes of secondary hypertension include. The evaluation of a patient with hypertension depends upon the likely cause and the degree of difficulty in achieving acceptable blood pressure control since many forms of secondary hypertension cause treatmentresistant hypertension. Secondary hypertension happens when you have high blood pressure that is caused by a known disease or condition. Diagnosis of secondary hypertension with investigations nursing diagnosis for high blood pressure secondary hypertension differential diagnosis diagnosis high blood pressure age of patients of secondary hypertension may be 50 years. Pdf resistant hypertension is defined as uncontrolled blood pressure despite the use of three antihypertensive drugs, including a. Clinicians often consider secondary causes such as renal. When specific cause is evident but heredity, and various physiological parameters play a role in increasing blood pressure is known as essential hypertension. Hypertension due to secondary causes is less likely to be seen in elderly individuals. Recognition, diagnosis and treatment of secondary causes of hypertension lead to. Secondary hypertension an overview sciencedirect topics. Powerpoint is the worlds most popular presentation software which can let you create professional secondary hypertension powerpoint presentation easily and in no time.
The evidence for selecting which patients should undergo additional testing for potentially correctable secondary causes of hypertension is based on the prevalence of these causes in different age groups, case series of reversal of hypertension with effective treatment of the underlying cause, and clinical suspicion of a secondary cause that may be reversible. Secondary causes if you have high blood pressure hypertension there are about nine chances out of 10 that it will be essential hypertension or primary hypertension, which implies that you do not have any clear cause for it. Recognition and treatment of secondary causes of hypertension among patients with resistant hypertension may help to control blood. Estimating the pretest probability of a secondary identifiable cause of hypertension is problematic, because referral bias is a major problem in hypertension prevalence studies. Secondary hypertension is attributable to an underlying medical disorder. An attempt to detect secondary causes of hypertension is important due to the potential for cure with appropriate treatment. Primary aldosteronism is the most common form of secondary hypertension and is often associated with drugresistant hypertension. In most of these cases renal dysfunction resulting from sever chronic kidney disease or renovascular disease is the most common secondary cause. The prevalence of primary and secondary hypertension was determined in a random sample of 7455 swedish men aged 47 to 54 years. A secondary etiology may be suggested by symptoms e.
Secondary hypertension 510 it can be due to pathology in the renal, endocrine, vascular or neurogenic systems. High blood pressure might be the result of a secondary condition, such as sleep apnea, kidney problems, or even pregnancy. This material may not otherwise be downloaded, copied, printed. Early onset hypertension up to 85% of preadolescent children with hypertension have secondary cause most commonly renal parenchymal disease gn, congenital, reflux nephropathy may not present until adolescentyoung adult consider adding urine culture and renal ultrasonography as part of routine. I read with interest the article by salles and colleagues. High blood pressure, also called hypertension, is a common condition that is characterized by having a higher amount of pressure in your blood vessels than normal. Hypertension is estimated to affect up to 65 million adults in the usa.
Secondary causes of hypertension are uncommon in older patients 50 years of age and should not. Secondary hypertension or, less commonly, inessential hypertension is a type of hypertension which by definition is caused by an identifiable underlying primary cause. Secondary hypertension secondary causes of hypertension tab. Find powerpoint presentations and slides using the power of, find free presentations research about secondary hypertension ppt. In phaeochromocytoma there is anxiety, headache, weight loss, hyperglycemia. Secondary hypertension refers to arterial hypertension due to an identifiable cause.
Patients likely to have essential idiopathic or primary hypertension undergo a relatively limited. Noted among these are coarctation of the aorta, pheochromocytoma, adrenal hypercorticism, aldosteronism, and, preeminently, hyperreninemia secondary to renovascular disease. Preadolescent children with hypertension should be evaluated for possible secondary hypertension. Secondary hypertension is a type of hypertension with an underlying, potentially correctable cause. Introduction high blood pressure, or hypertension as the disease is known medically, is our most common chronic illness. This chapter aims to summarize the principal causes of secondary hypertension, how these may be diagnosed and their specific treatments.
The most common causes in children are renal parenchymal disease and. Secondary hypertension is one where the cause is known. A thorough medical history and physical examination can often give clues as to the presence of secondary causes of hypertension. Secondary hypertension has specific causes and is a complication of another health problem. Primary hypertension has no clear cause and is thought to be linked to genetics, poor diet, lack of exercise and obesity.
It has many different causes including endocrine diseases, kidney diseases, and tumors. Renal parenchymal diseasesprimary aldosteronismcushings syndromepheochromocytoma. This paper will address the most common secondary causes of resistant hypertension druginduced, obstructive sleep apnea, primary aldosteronism, and chronic kidney disease, which are frequently encountered in hypertensive patients and are, therefore, the. Basic concepts, types, pathogenetic factors hypertension. Thus, in patients with potentially reversible causes of hypertension, early detection. The regional consultation on hypertension prevention and control held in abu dhabi, united arab emirates, 2022 december 2003, acknowledged the need for a standardized response to the growing challenge of hypertension see annex 1. View and download powerpoint presentations on secondary hypertension ppt. Hypertension murtaghs general practice, 7e murtagh. Estimates of exactly how many americans have high blood pressure varythe american heart association and the national heart, lung, and blood.
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