Secondary Hypertension - Symptoms, causes and treatment

Secondary hypertension is a condition of high blood pressure caused by certain diseases. This condition is different from high blood pressure in general (primary hypertension) whose cause is unknown

Secondary hypertension can be caused by disorders of the blood vessels, kidneys, heart, or endocrine system. To treat secondary hypertension, the cause needs to be treated first, not just with lifestyle changes and administration of antihypertensive drugs.

Causes of Secondary Hypertension

Secondary hypertension can be caused by various he alth conditions, one of which is kidney disease. This happens because the kidneys produce a hormone that regulates blood pressure (renin).

When kidney disease occurs, the production of the hormone renin will also be disrupted, so that blood pressure increases. Some examples of kidney disease that can cause secondary hypertension are polycystic kidney disease and glomerulonephritis.

In addition to kidney disease, disorders of the adrenal glands can also cause secondary hypertension. The adrenal glands play a role in producing hormones that also help control blood pressure.

When experiencing a disorder, the adrenal glands will produce excessive hormones so that blood pressure can increase. Some types of disorders of the adrenal glands include:

• Cushing's Syndrome
• Conn's Syndrome
• Pheochromocytoma

Secondary hypertension can also be caused by other he alth problems, such as thyroid and parathyroid gland disease, sleep apnea, and coarctation of the aorta. Obesity and consumption of drugs, such as birth control pills, antidepressants, and non-steroidal anti-inflammatory drugs, can also trigger secondary hypertension.

Secondary Hypertension Symptoms

Secondary hypertension rarely causes symptoms. Symptoms that appear generally come from the underlying disease secondary hypertension and can only be known when the patient performs an examination for the disease.

However, there are several signs that may distinguish secondary hypertension from primary hypertension, including:

• Hypertension appears suddenly before the age of 30 years or after the age of 55 years.
• There is no family member of the patient suffering from hypertension.
• The patient is not obese.
• Blood pressure can reach more than 180/120 mmHg.
• High blood pressure cannot be treated with just one or two hypertension drugs (resistant hypertension).

When to see a doctor

Long-term use of corticosteroids can cause Cushing's syndrome. Talk to your doctor about the benefits and risks of using it if you are taking corticosteroid medications long term.

Some of the diseases that are treated with long-term corticosteroids are autoimmune diseases or asthma.

Blood pressure checks should be done regularly, especially if you suffer from diseases that can cause secondary hypertension. Consult again with the doctor regarding when and how many times the blood pressure check should be done.

Secondary Hypertension Diagnosis

In diagnosing secondary hypertension, the doctor will ask about the symptoms experienced by the patient and will check the medical history. Next, the doctor will take blood pressure measurements. Physical examination is also done to detect other abnormalities that can cause blood pressure to rise.

Then the doctor will conduct a follow-up examination to find the cause of secondary hypertension. The inspections carried out include:

• Blood test
• Urine test
• USG
• Electrocardiogram (ECG)

Secondary Hypertension Treatment

Treatment of secondary hypertension is treating the underlying cause of the disease. If secondary hypertension is caused by a tumor or abnormality in the blood vessels, surgery can be performed.

Antihypertensive drugs will also be given to lower blood pressure. Some of these antihypertensive drugs are:

• ACE inhibitors, such as captopril and lisinopril
• ARBs, such as candesartan and valsartan
• Calcium antagonist drugs, eg amlodipine
• Diuretics, such as furosemide
• Beta-blocking drugs, such as atenolol and carvedilol
• Renin blocking drugs, eg aliskiren

Secondary Hypertension Complications

Secondary hypertension can cause complications if the treatment for hypertension or the underlying disease is not appropriate. Here are some complications that can occur:

• Thickening of arteries or atherosclerosis
• brain aneurysm
• Disorder of kidney function
• Heart failure
• Visibility
• Decreased brain function
• Metabolic syndrome

Prevention of Secondary Hypertension

The right way to prevent secondary hypertension is to treat the cause of the secondary hypertension. Meanwhile, to prevent hypertension in general, apply a he althy lifestyle, for example:

• Eat foods high in fiber and low in fat, such as fruits, vegetables, whole grains, and low-fat dairy products
• Reducing consumption of high-s alt foods
• Maintaining an ideal body weight, to prevent obesity which can worsen hypertension
• Exercise regularly
• Limiting alcohol consumption and quitting smoking
• Manage stress well, for example by doing meditation or yoga