What causes secondary high blood pressure and what should a patient pay attention to?

We will talk about secondary forms of arterial hypertension, which are also called symptomatic, as well as the main causes and characteristics of these disorders.

High and prolonged blood pressure is always dangerous due to its harmful consequences, so it is important to know about this condition and fight it.

Statistics show that among all cases of high blood pressure, symptomatic hypertension accounts for only 10%.

At first glance, it may seem that this is not a very large share of all cases. But symptomatic hypertension is a very serious condition due to its own characteristics. We will talk about the characteristics below. For convenience, we will sometimes shorten the expression “blood pressure” to “BP”.

What is secondary (symptomatic) arterial hypertension? Secondary hypertension is always a symptom of some disease. Due to a certain underlying disease, the regulation of blood vessels and the heart is disrupted in such a way that the pressure increases. Therefore, any specific disease that is accompanied by high blood pressure is the cause of symptomatic arterial hypertension.

Let’s list the groups of pathologies in which blood pressure increases. Any disease from the groups below can be considered the cause of secondary hypertension.

Group 1: pathologies in the nervous system.
Group 2: kidney pathologies,
Group 3: pathologies in the endocrine system.
Group 4: tumors.
Group 5: pathologies due to taking medications.
Group 6: pathologies in hemodynamics.

Let’s look at some diseases from each group.

Group 1. Hypertension may occur after a brain injury, some encephalitis, cerebral vascular ischemia.

Group 2. Blood pressure may increase with a number of kidney diseases. Inflammatory: glomerulonephritis, pyelonephritis, polycystic kidney disease and other diseases.

Group 3. Some endocrine diseases may also be accompanied by high blood pressure. These may include diseases of the adrenal glands: pheochromocytoma, aldosteronism; diseases of the pituitary gland: Itsenko-Cushing’s disease, acromegaly; diseases of the thyroid gland (thyrotoxicosis).

Group 4. Tumors. High blood pressure can usually appear with tumors that arise in organs involved in the regulation of the cardiovascular system. In particular, these are tumors of the brain, kidneys or endocrine glands.

Group 5. High blood pressure can be a kind of side effect of taking certain medications. For example, the use of hormonal drugs, some non-steroidal anti-inflammatory drugs (NSAIDs), and others.

Group 6. Sometimes some mechanical disorders in the circulatory system can be accompanied by increased pressure. In other words, these are disorders when hemodynamics worsens, that is, blood flow parameters change. In general, we can say that blood flow can decrease due to various kinds of obstacles in its path: extravascular, intravascular and intramural. These are such pathologies: coarctation of the aorta; atherosclerotic plaques of the renal, vertebral or carotid arteries; compression of the carotid, vertebral or renal arteries by external structures (muscles, bones, tumors, bends, prolapse of the kidneys).

What should a patient pay attention to with high blood pressure?

Point 1. Never make a final diagnosis for yourself. Only a doctor can make a diagnosis. Otherwise, there are cases when a patient decides that he has ordinary hypertension and starts taking medications that a pharmacist, a friend, or a relative advised him (unfortunately, such cases are observed).

Point 2. First of all, you should always try to exclude the presence of secondary arterial hypertension!!! Do not rush to agree with your doctor if your doctor makes a diagnosis of “essential hypertension”. It is not uncommon for a doctor to miss symptomatic hypertension for one reason or another. Be persistent: in any case, this is a matter of your health and well-being. If you start treating a patient for primary hypertension, then there will be no benefit, but rather harm.

If a patient begins to discover high blood pressure in himself, then here are the pathological features that the patient needs to pay attention to:

• age range. Symptomatic hypertension is usually characteristic of people who are either under 20 or over 60 years old.
• the presence of a disease that can be attributed to the above groups. For example, if a patient knows that he has a kidney disease (in this case, these are diseases from group 2, see above) and high blood pressure has appeared, then one can suspect that this hypertension is a renal complication.
• sudden development of arterial hypertension with persistent high blood pressure.
• malignant course of blood pressure.
• poor response to standard therapy used for primary hypertension.

That is, if a patient has noticed one or more of these features, then he should suspect the presence of symptomatic hypertension.

3rd point. I would like to deliberately draw your close attention to this, dear reader! There are frequent cases when pathologies with hemodynamic disturbances (in this case, these are diseases from group 6, see above) are missed by doctors and treated as essential hypertension.

Here are some examples to illustrate.

Example 1. A patient may have a prolapsed kidney. This causes a bend in the renal artery, which disrupts blood flow in this artery, resulting in a compensatory increase in blood pressure.

Example 2. A patient has suffered a neck injury. The cervical structures have shifted and begun to compress the vertebral arteries, causing the body to respond by increasing blood pressure.

Example 3. Atherosclerotic plaques are found in the patient’s carotid arteries. These plaques have changed the blood flow to the brain. The body can begin to compensatory increase blood pressure in order to supply the brain with enough blood.

Now imagine that these patients are treated according to standard protocols provided for primary hypertension. How much benefit will this bring?

In general, take care of yourself and be healthy!