Are you taking medication for your blood pressure but it is not properly controlled? Or do you have high blood pressure even though you are young? You may think that this is what high blood pressure is. But not every high blood pressure condition can have a specific cause. Sometimes, another disease in our body, a medicine we take, can be the cause of this high blood pressure. Today, we are talking about high blood pressure that occurs due to such a specific cause, that is, secondary hypertension .
What is Secondary Hypertension?
Simply put, this refers to high blood pressure that is caused by a specific identifiable cause , such as another disease in our body or a medication we are taking.
The normal blood pressure that most of us know, as doctors say, cannot be found for Primary Hypertension . It is influenced by many factors such as our genes, lifestyle, what we eat, and lack of exercise. But in `Secondary Hypertension`, it is not like that, we can point our finger at it and say, `Ah... this is the reason for the pressure'.
Imagine this. The water coming from your faucet has decreased. You check to see if there is water in the tank. There is water. So what is the problem? Maybe something is stuck inside a water pipe. That's how it is with this. The pressure is high, but the reason for that is not a problem with the pressure itself, but a problem somewhere else in the body.
Doctors used to think that only 5% to 10% of people with high blood pressure had secondary hypertension. But new research suggests that the number could be much higher, because the condition is often misdiagnosed and treated as normal blood pressure.
What are the main causes of secondary hypertension?
Now you might be wondering what kind of diseases can cause this. Check out this list. These are the most common causes. Let's look at each of these in more detail.
| Cause | A simple explanation |
|---|---|
| Obstructive Sleep Apnea | During sleep, the muscles in the throat relax and the airway becomes blocked, causing breathing to stop for a moment. At this time, the body's oxygen levels decrease, putting more strain on the heart. As this continues, blood pressure increases. |
| Renal Artery Stenosis | The kidneys are a key organ that controls blood pressure in our body. When the blood vessels that supply them become narrow, the kidneys don't get enough blood. The kidneys then think that the blood pressure in the body is low, so they release hormones that increase the pressure. |
| Hormonal Problems | For example, in conditions like Primary Aldosteronism (Conn's Syndrome) and Cushing Syndrome , the hormones that control the amount of salt and water in the body are produced in excess. This causes blood pressure to rise. Pressure can also change due to increased (Hyperthyroidism) or decreased (Hypothyroidism) activity of the thyroid gland. |
| Renal Parenchymal Disease | Diseases that damage the kidneys themselves make them unable to properly regulate the amount of fluid and salt in the body, which can also cause high blood pressure. |
| Some medications and other substances | Some of the things we use, such as painkillers, birth control pills, and cold medicines, can increase blood pressure. In addition, excessive alcohol, tobacco, and other drug use can also have an effect. |
| Some types of tumors | Tumors that develop in the adrenal glands, such as pheochromocytoma and paraganglioma, produce excessive amounts of hormones. These hormones can cause a sudden increase in heart rate and blood pressure. |
| Congenital heart disease (Coarctation of the Aorta) | This occurs when the aorta, the main blood vessel that carries blood from the heart to the body, becomes narrowed. This causes the heart to work harder to pump blood through the narrowed area. This increases the pressure. |
Medications and other things that can increase blood pressure
Some of the medications we take can also unknowingly increase our blood pressure.
- Some medicines for colds and allergies (Decongestants)
- Painkillers (NSAIDs)
- Birth control pills (Oral Contraceptives)
- Some antidepressants
- Corticosteroids - e.g. prednisone
- Immunosuppressants
- Some drugs for cancer
Most importantly: Even if you suspect that a medication your doctor has prescribed is causing your blood pressure to rise, never stop taking it on your own. It is essential to talk to your doctor first and seek advice.
In addition, excessive alcohol consumption, nicotine use, some herbal supplements , and illegal drug use are also major causes of high blood pressure.
What are the symptoms of secondary hypertension?
In most cases, there are no symptoms associated with `Secondary Hypertension`. This means that you may not notice much difference in your blood pressure (unless it becomes dangerously high). However, you may experience symptoms of the underlying condition that is causing the high blood pressure .
For example, if your blood pressure is caused by a thyroid problem, you may experience symptoms like increased heart rate, excessive sweating, and weight loss. Similarly, symptoms will vary depending on the underlying cause.
At what point does a doctor become suspicious about this?
There are several things that may make your doctor suspect that you have secondary hypertension. These are called "red flags" for the condition.
- If your blood pressure is normally under control and suddenly increases.
- If a person under the age of 30 develops high blood pressure.
- If the pressure suddenly rises dangerously (Hypertensive Crisis).
- If your blood pressure cannot be controlled despite using three or more medications (Resistant Hypertension).
In addition to this, if a young child's blood pressure increases before reaching puberty , that is also a major factor that should prompt us to look for another cause.
What are the risks if left untreated?
If this condition is not treated, long-term high blood pressure can damage the heart, blood vessels, brain, and kidneys. We call this hypertensive heart disease .
Also, complications can arise from the underlying medical condition that caused the pressure. But there is a good side to this. Identifying `Secondary Hypertension` can be the first clue to identifying another disease that was hidden in your body. Therefore, treating it is a good step to manage the underlying disease as well.
How do doctors diagnose this disease?
Because there are so many causes, it can sometimes take a while to arrive at an accurate diagnosis. The doctor may have to rule out some causes and investigate others in more depth.
The testing process typically goes like this:
1. Initial examination: First, your doctor will examine you physically, ask about your medical history, medications you take, and supplements you take. He will also talk about your diet, salt intake, and alcohol consumption.
2. Basic tests: Then an EKG (ECG) test, some basic blood and urine tests are done.
3. Specialized tests: If the cause is not clear from the initial tests, further specialized tests are performed depending on the suspected medical condition.
- Kidney Ultrasound
- CT Angiogram or MRA (a special scan that looks at blood vessels)
- Sleep study or polysomnography
- More blood and urine tests to look at specific hormone levels
How is it treated?
The treatment for this depends entirely on the cause of the pressure. There is no one-size-fits-all treatment. Your doctor will develop a treatment plan that is right for you and explain it to you.
Your treatment plan may include:
- Taking medication to lower blood pressure.
- Taking other medications to treat an underlying medical condition.
- Making dietary changes (e.g. reducing salt).
- Limiting alcohol consumption.
- Quitting smoking completely.
- Engaging in regular physical exercise.
- If you have trouble breathing during sleep, use a device such as a CPAP machine .
- In some cases, surgery or other medical procedures may be necessary.
Treating this condition can yield very good results. Once the underlying cause is properly treated, your blood pressure can return to normal. If your blood pressure continues to be a little high, you may need to continue taking medication to control it. The most important thing is to find the cause and treat it properly.
Take-Home Message
- Not all high blood pressure conditions are the same. There may be a specific identifiable cause for your blood pressure.
- If your blood pressure is not controlled with medication, if it started at a young age, or if it suddenly increases, be sure to talk to your doctor about it.
- When the underlying cause is treated, the pressure can often be controlled, and sometimes even completely cured.
- Avoid stopping a medication prescribed by a doctor on your own. If you have any questions or concerns, discuss them with your doctor first.
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