Although most cases of hypertension are without an underlying cause i. Most patients with high blood pressure bp have essential hypertension htn or wellknown forms of secondary htn such as renal parenchymal disease, renal artery stenosis, hyperaldosteronism, or pheochromocytoma. Disorders including sleep apnea, tumors, and kidney failure can all cause hypertension to occur as a side effect. Secondary hypertension differs from the usual type of high blood pressure primary hypertension or essential hypertension, which is often. Secondary hypertension affects a small but significant number of the hypertensive population and, unlike primary hypertension, is a potentially curable condition. In the majority of patients with hypertension the cause cannot be found. Lifestyle modifications medication trainingskill building stage 1 hypertension tertiary prevention 140159 or 9099 assess for other risk factors pcp for med management win 2. Hypertension puts strain on the heart, leading to hypertensive heart disease and coronary artery disease if not treated. Chronic kidney disease ckd is a common cause of high blood pressure, as the kidneys no longer filter. Although lowering secondary hypertension can be difficult, making the same lifestyle changes you would make if you had primary high blood pressure can help. A number of factors can lead to the health issue that results in high blood pressure.
Secondary hypertension diagnosis and treatment mayo clinic. Another type, secondary hypertension, is caused by various toxicities, iatrogenic disease, and congenital diseases. Nov 18, 2009 secondary hypertension occurs in only 5 to 10 percent of those with high blood pressure. Specific recommendations are given as to evaluation and. Offer antihypertensive drug treatment to people of any age with stage 2 hypertension. However, the decision to do surgery is often guided by the age and general health of the patient. Try the dietary approaches to stop hypertension dash diet, which emphasizes fruits, vegetables, whole grains and lowfat dairy foods. This article discusses the common causes of secondary hypertension. 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. Primary hypertension has no clear cause and is thought to be linked to genetics, poor diet, lack of exercise and obesity. Pdf secondary hypertension occurs in 510% of cases in the patient population.
Secondary hypertension to sc ptsd 70% veterans benefits. People with cushings disease produce too much of a hormone called cortisol that. You may be able to keep your hypertension under control by monitoring your diet, reducing your salt intake, exercising, and relaxing in order to reduce stress levels. About 10% of patients with hypertension have a secondary. Secondary hypertension symptoms and causes mayo clinic. Hypertension due to secondary causes is less likely to be seen in elderly individuals. In 5 to 10 % of patients a reversible cause for hypertension may be identified. See box 351 for factors that suggest the presence of secondary hypertension, and table 352 for etiologies and screening techniques. If hypertension occurs in individuals younger than 65 years of age, a secondary cause of high blood pressure should be ruled out. Hypertension is the single biggest contributor to the global burden of disease, and is the most common chronic medical condition presenting to primary care physicians in singapore. Among these, the major categories are renal parenchymal disease which includes chronic kidney disease and polycystic kidney. Hypertension is also a major risk factor for stroke, aneurysms of the arteries e. Patients likely to have essential idiopathic or primary hypertension undergo a relatively limited. Primary hypertension can be defined as an elevated bp of unknown cause due to cardiovascular risk factors resulting from changes in environmental and lifestyle factors.
Coexistence of hypertension and related chronic conditions 11. Meets criteria for htnmeets criteria for htn results from an identifiable, potentially correctable cause accounts for significant number of resistant htn cases estimated to account for 515% of cases of htn prevalence of hypertension in adults between 2030% 5070 million people. Secondary hypertension is common in clinical practice if a broad definition is applied. Started in 1995, this collection now contains 6769 interlinked topic pages divided into a tree of 31 specialty books and 732 chapters. Hypertension is classified as either primary essential hypertension or secondary hypertension. Learn about secondary hypertension, high blood pressure caused by another condition or disease, from experts at cleveland clinic. It is much less common than the other type, called essential hypertension, affecting only 5% of hypertensive patients. When the kidneys blood supply is reduced by a narrowing called renal artery stenosis, the kidney produces high levels of a hormone called renin. The average of two or more office visits on separate days based on either systolic or diastolic. 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. 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 1. Instead, hypertension occurs because your genes, diet, and lifestyle. Causes of hypertension high blood pressure primary cause is unknown contributing conditions.
Experts have found that in most people, this form of hypertension seems to occur as a complication of some other medical condition in the body. George mansoor s volume on secondary hyper tension is an important contribution to the field of clinical hypertension and vascular diseases, since it brings up to date the numerous diagnostic and therapeutic advances in the evaluation for secondary types of hyper tension. If you treat the underlying condition, the hypertension will subside. Estimates of exactly how many americans have high blood pressure varythe american heart association and the national heart, lung, and blood institute put the figure at about 5560 million, but. Accordingly, the prevalence of hypertension increases with increasing age, such that more than one of every two adults older than 60 years of age has hypertension. Antihypertensive treatment and secondary prevention of. A variety of therapeutic agents can increase blood pressure.
Hypertensive nephrosclerosis, which causes renal dysfunction on the basis of essential hypertension, and diabetic nephropathy are discussed in. Treatment of secondary forms of hypertension differs widely. Secondary hypertension is a less common form of the disease that occurs because of a specific condition. The renal arteries are the major blood vessels that bring blood to each kidney. A secondary etiology may be suggested by symptoms e. Renal parenchymal hypertension, caused by renal parenchymal disorders, is a common form of secondary hypertension, accounting for 25% of. The other type of hypertension is called secondary hypertension. While the majority of patients have essential hypertension that does not have an identifiable cause, it is important to recognise secondary causes of hypertension table i, as. For some people, kidney disease can cause hypertension. Detailed summary from the 2017 guideline for the prevention.
Environmental factors such, as excess salt intake will raise someones blood. High blood pressure, also known as hypertension, is classified as essential primary or secondary. Pdf secondary hypertension, issues in diagnosis and treatment. Recognition, diagnosis and treatment of secondary causes of hypertension lead to good. Secondary hypertension is defined as hypertension that occurs due to detectable factors. Objective to evaluate the effect of antihypertensive treatment on secondary prevention of cvd events and allcause mortality among persons without. Secondary hypertension in adults pubmed central pmc.
The guidelines are intended to benefit physicians at primary, secondary and tertiary level. Jan 01, 2003 secondary hypertension is elevated blood pressure that results from an underlying, identifiable, often correctable cause. In order to treat secondary hypertension, your doctor will address the condition or disorder that is causing the hypertension adrenal gland disorder, kidney disease, sleep apnea, etc. Secondary hypertension is a type of hypertension with an underlying, potentially correctable cause.
Secondary hypertension is attributable to an underlying medical disorder. Therefore, when assessing accelerated or poorly controlled blood pressures, one should always. Secondary hypertension has specific causes and is a complication of another health problem. In such cases, when the root cause is treated, blood pressure. Diagnosing secondary hypertension american family physician. Coming to secondary hypertension, it may not be an idiopathic condition, unlike the primary one. High blood pressure, or hypertension as the disease is known medically, is our most common chronic illness. The treatment of secondary hypertension depends on its cause. There are two forms of kidney diseases causing hypertension namely renal parenchymal and renovascular.
Hypertension may be classified by aetiology into two groups. Most physicians are less aware of other secondary forms of htn such as druginduced htn. Some patients have hypertension secondary to primary hypertension or secondary to degenerative disease, such as diabetes, nephritis and hyperthyroidism. This overabundance of catecholamines causes blood pressure bp. Adequate management of secondary hypertension can regulate both the original health issue and the elevated blood pressure and minimizes the risk of a serious complication. In these cases, there is a definite, identifiable cause for the disease.
Secondary hypertension, where a cause can be identified,accounts for less than 5 per cent. Fewer than 10% of patients have secondary hypertension. In most of these cases renal dysfunction resulting from sever chronic kidney disease or renovascular disease is the most common secondary cause. For people aged under 40 years with stage 1 hypertension and no evidence of target organ damage, cardiovascular disease, renal disease or diabetes, consider seeking specialist evaluation of secondary causes of hypertension and a more detailed assessment of potential target organ damage. Office blood pressure 80 or higher if high risk diabetic mellitus, chronic kidney disease, framingham risk score 10 % or greater, angina, myocardial infarction, carotid artery disease, peripheral arterial disease, abdominal aortic aneurism, heart failure. A number of factors can lead to the health issue that results in. In about 10% of people, high blood pressure is caused by another disease. Powerpoint is the worlds most popular presentation software which can let you create professional secondary hypertension powerpoint presentation easily and in no time.
Free download secondary hypertension powerpoint presentation. Patients likely to have essential idiopathic or primary hypertension undergo a relatively limited evaluation because extensive laboratory. Essential hypertension is diagnosed when no identifiable cause can be found and accounts for 95 per cent of all cases of hypertension. Jun 06, 2019 secondary hypertension can be related to damaged kidneys or to an abnormal narrowing of one or both renal arteries. This helps you give your presentation on secondary hypertension in a conference, a school lecture, a business proposal, in a webinar and business and professional representations the uploader spent hisher valuable time to. Preadolescent children with hypertension should be. Secondary hypertension an overview sciencedirect topics. Secondary hypertension, issues in diagnosis and treatment article pdf available in primary care clinics in office practice 414 december 2014 with 152 reads how we measure reads. Context cardiovascular disease cvd risk increases beginning at systolic blood pressure levels of 115 mm hg. While the majority of patients have essential hypertension that does not have an identifiable cause, it is important to recognise secondary causes of hypertension. Secondary hypertension is a type of high blood pressure that is caused by a medical condition.
Blood pressure components, risk, and comorbidities of hypertension 10. When secondary hypertension results from a tumor or a blood vessel abnormality, surgery may be recommended. Secondary hypertension occurs in only 5 to 10 percent of those with high blood pressure. Hypertension may result from diabetic and inflammatory glomerular diseases, tubular interstitial disease, and polycystic kidneys. Slows av node conduction so used for atrial flutter. Another cause of hypertension is a disease called cushings disease. The condition of having elevated blood pressure is called hypertension. Pdf secondary hypertension, issues in diagnosis and. This helps you give your presentation on secondary hypertension in a conference, a school lecture, a business proposal, in a webinar and business and professional representa. Nov 11, 2012 internal medicine secondary hypertension 1.
Essential hypertension does not have an apparent cause. Hypertension causes and treatment flashcards quizlet. Clinicians often consider secondary causes such as renal. Renal disease renal parenchymal disease is the most common cause of secondary hypertension. Only about 5 to 10 percent of hypertension cases are thought to result.
Use of antihypertensive medications among patients with a history of cvd or diabetes and without hypertension has been debated. Author links open overlay panel ehud grossman md a b. An algorithm showing the general strategy to help screen for factors involved in secondary hypertension is presented. Endocrine causes of secondary hypertension sica 2008 the. Druginduced hypertension is a type of secondary hypertension. It has many different causes including endocrine diseases, kidney diseases, and tumors. Jan 14, 2009 renal parenchymal hypertension, caused by renal parenchymal disorders, is a common form of secondary hypertension, accounting for 25% of all hypertension. For some patients, antihypertensive medications may be a safer option than. Secondary hypertension can be triggered by certain health conditions that involve the kidneys, heart, arteries or the endocrine system and it can also happen during pregnancy. Verapamil mostly works on cardiac muscle, slows entry of calcium during phases 2 and 3 of the cardiac action potential. Renal parenchymal diseasesprimary aldosteronismcushings syndromepheochromocytoma. Diltiazem affects cardiac smooth muscle, causes mild decrease in svr, bp and co.