primary and secondary hypertension pdf

Primary and secondary hypertension pdf

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The Diagnosis of Essential and Secondary Hypertension in Adults

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Introduction

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Patient information: See related handout on underlying causes of high blood pressure , written by the authors of this article. See CME Quiz. Most patients with hypertension have no clear etiology and are classified as having primary hypertension.

The Diagnosis of Essential and Secondary Hypertension in Adults

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.

Like primary hypertension, secondary hypertension usually has no specific signs or symptoms, even if your blood pressure has reached dangerously high levels. If you've been diagnosed with high blood pressure, having any of these signs may mean your condition is secondary hypertension:. If you have a condition that can cause secondary hypertension, you may need your blood pressure checked more frequently. Ask your doctor how often to have your blood pressure checked. Many different diseases and health conditions can cause secondary hypertension.

Several kidney diseases may cause secondary hypertension, including:. Renovascular hypertension. This type of high blood pressure is caused by narrowing stenosis of one or both arteries leading to your kidneys. Renovascular hypertension is often caused by the same type of fatty plaques that can damage your coronary arteries atherosclerosis or a separate condition in which the muscle and fibrous tissues of the renal artery wall thicken and harden into rings fibromuscular dysplasia.

Medical conditions affecting hormone levels also may cause secondary hypertension. These conditions may include:. Sleep apnea. In this condition, often marked by severe snoring, breathing repeatedly stops and starts during sleep, causing you to not get enough oxygen.

Not getting enough oxygen may damage the lining of the blood vessel walls, which may make it harder for your blood vessels to control your blood pressure. In addition, sleep apnea causes part of the nervous system to be overactive and release certain chemicals that increase blood pressure. As you gain weight, the amount of blood flowing through your body increases.

This puts added pressure on your artery walls, increasing your blood pressure. Being overweight also increases the heart rate and makes it harder for your blood vessels to move blood. In addition, fat deposits can release chemicals that raise blood pressure. Medications and supplements. Various prescription medications — such as pain relievers, birth control pills, antidepressants and drugs used after organ transplants — can cause or worsen high blood pressure in some people.

Over-the-counter decongestants and certain herbal supplements, including ginseng, licorice and ephedra ma-huang , may have the same effect. Many illegal drugs, such as cocaine and methamphetamine, also increase blood pressure. The greatest risk factor for developing secondary hypertension is having a medical condition that can cause high blood pressure, such as kidney, artery, heart or endocrine system problems. Secondary hypertension can worsen the underlying medical condition you have that's causing your high blood pressure.

If you don't receive treatment, secondary hypertension can lead to other health problems, such as:. Metabolic syndrome. This syndrome is a cluster of disorders of your body's metabolism — including increased waist circumference, high triglycerides, low high-density lipoprotein HDL cholesterol the "good" cholesterol , high blood pressure and high insulin levels. If you have high blood pressure, you're more likely to have other components of metabolic syndrome. The more components you have, the greater your risk of developing diabetes, heart disease or stroke.

Mayo Clinic does not endorse companies or products. Advertising revenue supports our not-for-profit mission. Don't delay your care at Mayo Clinic Schedule your appointment now for safe in-person care. This content does not have an English version. This content does not have an Arabic version. Request an appointment. Overview Secondary high blood pressure secondary hypertension is high blood pressure that's caused by another medical condition.

Request an Appointment at Mayo Clinic. Share on: Facebook Twitter. Show references Basile J, et al. Overview of hypertension in adults. Accessed Jan. Papadakis MA, et al. Systemic hypertension. McGraw-Hill; McKean SC, et al. Secondary hypertension. In: Principles and Practice of Hospital Medicine. Jameson JL, et al. In: Harrison's Manual of Medicine. Accessed Dec. Fuster V, et al. Pathophysiology of hypertension.

In: Hurst's the Heart. Bonow RO, et al. Systemic hypertension: Management. Elsevier; Mayo Clinic Marketplace Check out these best-sellers and special offers on books and newsletters from Mayo Clinic.

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While many diagnostic tools exist to assess SH, physicians and other healthcare providers who treat hypertension may find it difficult to detect due to the multiple etiologies and suboptimal recognition of the condition. As a teaching and referral unit, the Center created a systematic and standardized approach to screen patients with hypertension in search for an identifiable cause for their HBP, based on contemporary guideline recommendations and local expertise 7 - 9. Utilizing the methods developed in the Center, this approach, known as the CHIC Protocol, could constitute a valuable tool for early recognition and accurate diagnosis of SH in clinical practice. In , we analyzed patient data from the preceding decade and screened for SH using this Protocol, identifying a higher level in the prevalence of SH among our patients, compared to previously published world-wide reports 1 - 9. Although secondary causes of hypertension are common in patients with resistant hypertension, a higher prevalence of SH persisted independent of the measured severity of BP values and SH was also identified in patients with moderate hypertension.

Secondary hypertension happens when you have high blood pressure that is caused by a known disease or condition. 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. Blood pressure is typically measured with an inflatable cuff that is placed around your arm. When taking your blood pressure, your healthcare provider is looking for two measurements:. The two measurements are listed together, systolic on top of diastolic. Once your blood pressure rises above this measurement, your healthcare provider will start to monitor you for high blood pressure.

Introduction

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.

Improved identification of secondary hypertension: use of a systematic protocol

Hypertension HTN or HT , also known as high blood pressure HBP , is a long-term medical condition in which the blood pressure in the arteries is persistently elevated. High blood pressure is classified as primary essential hypertension or secondary hypertension.

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Hypertension is the medical term for high blood pressure. The definition of high blood pressure changed in , when the American College of Cardiology and the American Heart Association revised their hypertension guidelines. A blood pressure between and mm Hg for the top systolic number and more than 80 mm Hg diastolic for the bottom number is considered elevated. Instead, they recommend implementing lifestyle changes. Read on to learn about the different types of hypertension and what you can do to manage high blood pressure. The new classification system puts more people into the elevated category who were previously considered prehypertensive.

Underlying causes of hypertension were found in patients 7. Eighty-seven patients 2. Two hundred ten patients 5. Excess deaths in the renal group were attributed to renal failure International Classification of Diseases [ ICD ] to and vascular causes ICD to but not to cancer ICD to ; to or other nonvascular disease. These results suggest that investigation of hypertension for an underlying cause will reveal a small number of patients with treatable disorders, of whom only a few will be cured by specific intervention, and a moderate number with irreversible disease who are at high risk of myocardial infarction and stroke.

Secondary hypertension is elevated blood pressure that results from an underlying, identifiable, often correctable cause. Only about 5 to 10 percent of hypertension cases are thought to result from secondary causes. The ABCDE mnemonic can be used to help determine a secondary cause of hypertension: A ccuracy of diagnosis, obstructive sleep A pnea, A ldosteronism, presence of renal artery B ruits suggesting renal artery stenosis , renal parenchymal disease B ad kidneys , excess C atecholamines, C oarctation of the aorta, C ushing's syndrome, D rugs, D iet, excess E rythropoietin, and E ndocrine disorders.

Common Causes of Secondary Hypertension

Stefano F. Rimoldi, Urs Scherrer, Franz H. Messerli, Secondary arterial hypertension: when, who, and how to screen? Because secondary forms are rare and work up is time-consuming and expensive, only patients with clinical suspicion should be screened. In recent years, some new aspects gained importance regarding this screening.

Stefano F. Rimoldi, Urs Scherrer, Franz H. Messerli, Secondary arterial hypertension: when, who, and how to screen? Because secondary forms are rare and work up is time-consuming and expensive, only patients with clinical suspicion should be screened. In recent years, some new aspects gained importance regarding this screening. In particular, increasing evidence suggests that 24 h ambulatory blood pressure BP monitoring plays a central role in the work up of patients with suspected secondary hypertension. Moreover, obstructive sleep apnoea has been identified as one of the most frequent causes.

It is a heterogeneous condition with a number of etiologies and multiple, interacting genetic and environmental factors 2.

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    PDF | The prevalence of primary and secondary hypertension was determined in a random sample of Swedish men aged 47 to 54 years.

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    Secondary hypertension is uncommon in traditional primary care practice, yet it may cause major morbidity for a subset of patients. Depend- ing on the.

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