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Secondary arterial hypertension is also referred to as symptomatic because it is not a primary disease in itself, but is only a secondary symptom and consequence of a condition in the course of which hypertension occurs. Symptoms experienced by a person with secondary hypertension are the same as with primary hypertension. In addition to the symptoms characteristic of hypertension, the patient experiences other ailments related to the underlying disease.
What is secondary hypertension?
Secondary arterial hypertension is also called symptomatic hypertension because it is not a separate entity, but a symptom of a medical condition in the course of which hypertension occurs. This type of ailment is diagnosed in about 5% of patients. Finding the causes of secondary hypertension is not a big problem. The presence of symptoms of a condition causing secondary hypertension and high blood pressure in a patient raises the suspicion of secondary hypertension. The diagnosis of this ailment is quite important because it allows not only to effectively remove hypertension and normalize it without the need to take pharmacological agents for a long time.
Secondary hypertension – Causes
Among the most common causes of secondary hypertension, that is, among the ailments in the course of which elevated blood pressure appears, there are various disease states and anomalies in the development of arterial blood vessels supplying the kidneys. As a result of renal ischemia, biochemical mechanisms are triggered, leading to an increase in blood pressure in the final link.
Other diseases that cause an increase in blood pressure include certain ailments of the endocrine glands with hormonal disorders and brain tumors and injuries, inflammation of the brain and meninges, lead poisoning, etc.
The causes of secondary arterial hypertension can be divided into:
- rare such as: Cushing’s syndrome; overactive thyroid gland; anemia; lead poisoning; phaeochromocytoma; arteriovenous fistulas; porphyria; congenital adrenal hyperplasia; Guillain-Barré syndrome; acromegaly; hyperparathyroidism; aortic regurgitation; aortic stenosis;
- common, such as: Conn’s syndrome; taking preparations in the form of glucocorticoids, non-steroidal anti-inflammatory drugs, oral contraceptives; narrowing of the renal artery / arteries; obstructive sleep apnea
Secondary arterial hypertension – symptoms
The most common cause of secondary hypertension is parenchymal kidney disease. Patients with this disease develop symptoms such as swelling of the feet, ankles and hands, swelling around the eyes, frequent urination, pain when urinating, blood in the urine, cloudy urine with a pungent odor like ammonia, increased blood pressure.
Patients with obstructive sleep apnea and secondary hypertension develop headaches, fatigue, trouble concentrating, daytime sleepiness, and sometimes even depression. The most characteristic feature of sleep apnea is snoring with accompanying periods of apnea. Often there are dangerous arrhythmias.
In patients with Conn’s disease, aldosterone is excessively secreted. It causes not only an increase in pressure, but also hypertrophy and fibrosis of smooth muscles and the vessels of the heart. In addition, the secreted aldosterone has anticoagulant and pro-inflammatory properties. Hypertension in primary Conn’s syndrome is very often severe and does not respond to medication. This situation causes symptoms such as muscle weakness, tetany, paralysis, large amounts of urine, high thirst and muscle cramps.
There are characteristic symptoms of secondary arterial hypertension, they are:
- hypertension unresponsive to pharmacological agents,
- hypertension appearing before the age of 20 or over 50,
- pressure higher than 180/110 mm Hg,
- family history focused on kidney disease,
- arterial hypertension accompanied by tremors, excessive sweating and tachycardia,
- enlargement of the heart cavities,
- kidney failure
- eye fundus changes,
- left ventricular hypertrophy.
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How to recognize secondary arterial hypertension?
In the diagnosis of secondary arterial hypertension, it is important to monitor specific symptoms. On their basis, the patient can be referred for further additional tests. In diagnostics, pressure measurement as well as imaging tests of urine and blood are important.
Secondary arterial hypertension – treatment
Symptomatic treatment of secondary arterial hypertension is similar to that of primary hypertension. The effectiveness of the treatment is also dependent on the type and effectiveness of the treatment of the underlying disease causing the hypertension.
Prevention of secondary hypertension, i.e. symptomatic hypertension, consists in the thorough treatment of disease states which, in their development, may cause more or less persistent and high arterial hypertension (e.g. kidney diseases). All other recommendations regarding essential hypertension are also valid here. You need to change your lifestyle by eating a proper diet, consuming less alcohol, quitting cigarettes and introducing more physical activity into your life.
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