Essential hypertension does not have an apparent cause. Thus, in patients with potentially reversible causes of hypertension, early detection and treatment are important to minimizeprevent irreversible. In such cases, when the root cause is treated, blood pressure. Regardless of the cause, arterial pressure becomes elevated either due to an increase in cardiac output, an increase in systemic vascular resistance, or both. In about 10% of people, high blood pressure is caused by another disease. Hypertensive nephrosclerosis, which causes renal dysfunction on the basis of essential hypertension, and diabetic nephropathy are discussed in. Hypertension diagnosis and management effective date. Primary hypertension has no clear cause and is thought to be linked to genetics, poor diet, lack of exercise and obesity. Hypertension with certain specific additional signs and symptoms may suggest secondary hypertension, i. A secondary etiology may be suggested by symptoms e. In these cases, there is a definite, identifiable cause for the disease. Hypertension remains one of the most significant causes of mortality worldwide. Generating an epub file may take a long time, please be patient.
Blood pressure components, risk, and comorbidities of hypertension 10. Diabetes can damage your kidneys filtering system, which can lead to high blood pressure. If high blood pressure is untreated, the heart and arteries may become damaged and no. Blood pressure normally rises and falls throughout the day, but it can cause health problems if it stays high for a long time. In many cases, it is the result of an underlying condition. Workup for secondary hypertension cardiological society of india. One in three american adults has high blood pressurethats an estimated 67 million people. Secondary hypertension in a blood pressure clinic jama. The secondary renal outcome, dialysis or doubling of serum creatinine, was similar with telmisartan 189 2.
Underlying causes of hypertension were found in 297 patients 7. Secondary hypertension symptoms and causes mayo clinic. Apr 05, 2016 hypertension, its causes, types and management 1. Diffuse renal vasculitis with secondary hyperreninemia and hyperaldosteronism appears to be an important cause of hypertension in patients with systemic necrotizing vasculitis. Doctors call high blood pressure that is not due to another condition or disease primary.
Blood pressure bp thresholds and recommendations for treatment and. A number of conditions can cause secondary hypertension. Fewer than 10% of patients have secondary hypertension. Causes renal artery stenosis 35% of those with a secondary cause primary aldosteronism 1723% of rh cases, gra renal parenchymal disease osa pheochromocytoma cushings disease thyroid disease coarctation of aorta. When the kidneys blood supply is reduced by a narrowing called renal artery stenosis, the kidney produces high levels of a hormone called renin. A more aggressive evaluation for secondary causes of hypertension should be considered in certain clinical situations. 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. Secondary hypertension can be caused by a renal disease. A free powerpoint ppt presentation displayed as a flash slide show on id.
Powerpoint is the worlds most popular presentation software which can let you create professional secondary hypertension powerpoint presentation easily and in no time. It is much less common than the other type, called essential hypertension, affecting only 5% of hypertensive patients. Ppt secondary hypertension powerpoint presentation free. High blood pressure, or hypertension as the disease is known medically, is our most common chronic illness.
High blood pressure can lead to heart disease and strokeleading causes of death in the united states. If that is the case, it is called 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. The renal arteries are the major blood vessels that bring blood to each kidney. Nov 11, 2012 internal medicine secondary hypertension 1. Treatment of secondary forms of hypertension differs widely. High blood pressure, also known as hypertension, is classified as essential primary or secondary. Patients likely to have essential idiopathic or primary hypertension undergo a relatively limited. People with cushings disease produce too much of a hormone called cortisol that. After clinic measurements are confirmed, secondary causes of hypertension require consideration. The prevalence, reversibility, and mortality of secondary hypertension among 3783 patients with moderately severe nonmalignant hypertension attending the glasgow scotland blood pressure clinic were assessed. Jan 14, 2009 renal parenchymal hypertension, caused by renal parenchymal disorders, is a common form of secondary hypertension, accounting for 25% of all hypertension. These forms were compiled into one file and can be found on the esc website. Renal parenchymal hypertension, caused by renal parenchymal disorders, is a common form of secondary hypertension, accounting for 25% of.
Causes of secondary hypertension with clinical indications and diagnostic. The other type of hypertension is called secondary hypertension. The current prevalence of hypertension in children is estimated to be about 15%, with higher rates among minority adolescents. Examples of secondary causes of hypertension indications for a secondary cause of hypertension are. Secondary hypertension in adults pubmed central pmc. Another cause of hypertension is a disease called cushings disease. Nov 18, 2009 secondary hypertension occurs in only 5 to 10 percent of those with high blood pressure. Both can lead to severe, lifealtering, and possibly fatal consequences.
A number of factors can lead to the health issue that results in. Hypertension and serious mental illness hypertension high blood pressure is a common conditionaffecting 1 in 5 americansin which blood does not flow easily through the bodys blood vessels to vital organs such as the kidneys, heart, eyes, and brain. Outside the scope of this guideline is the management of secondary causes of htn, accelerated htn, acute htn in emergency. Renal parenchymal diseasesprimary aldosteronismcushings syndromepheochromocytoma. 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. Patients likely to have essential idiopathic or primary hypertension undergo a relatively limited evaluation because extensive laboratory. Primary hypertension ph also referred to as essential hypertension, previously considered a disease of adulthood, has now become increasingly common in the pediatric population largely due to the obesity epidemic 4,5. The number of cases secondary to renal and adrenal lesions has increased, with a corresponding reduction in the number of patients relegated to the category of essential hypertension. Despite appropriate therapy or even removal of the secondary cause, bp rarely ever returns to normal with. Diagnosing secondary hypertension american family physician. Secondary hypertension occurs in a significant proportion of adult patients 10%.
June 22, 2016 scope this guideline provides recommendations on how to diagnose and manage hypertension htn in adults aged. If the patient has an abrupt increase in bp measurement, consider lab workup for secondary hypertension. The patients medical history was notable for noncontrolled hypertension and oslerweberrendu disease, while his current medication included lercanidipine 20 mg. The chief causes of secondary hypertension are renal artery stenosis, primary aldosteronism, and, more recently, excess adrenal secretion of 18. Severe or resistant hypertension childadolescent worsening of previously stable hypertension malignant hypertension no other risk factors identified and age diagnosis and management effective date. Secondary forms of hypertension are rare and the origin could be. His physical examination was notable for a blood pressure of 156104 mmhg and a body mass index of 25 kgm2. Coexistence of hypertension and related chronic conditions 11.
In one patient, hypertension was easily controlled with the angiotensionconverting enzyme inhibitor captopril. This condition may be the sole cause for hypertension in an individual, or a contributing factor in a patient who already has primary hypertension. Secondary hypertension definition of secondary hypertension. For example, cushings syndrome frequently causes truncal obesity, glucose intolerance, moon face, a hump of fat behind the neckshoulder referred to as a buffalo hump, and purple abdominal.
A classification of secondary causes is shown in table 1. Secondary causes of resistant hypertension hypertension. Free download secondary hypertension powerpoint presentation. There are many known conditions that can cause secondary hypertension. Blood pressure is the force of blood against your artery walls as it circulates through your body. For some people, kidney disease can cause hypertension. Hypertensionprimary and secondary annals of internal. A number of factors can lead to the health issue that results in high blood pressure. Secondary hypertension is a type of hypertension with an underlying, potentially correctable cause. Jun 06, 2019 secondary hypertension can be related to damaged kidneys or to an abnormal narrowing of one or both renal arteries. It is important to diagnose and treat secondary causes of hypertension, as it can lead to cardiovascular and renal complications as well as increased healthcare costs if left undiagnosed.
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. Secondary hypertension occurs in 510% of cases in the patient population with primary hypertension. May 28, 2019 doctors suspect a link between hypertension, or high blood pressure, and diabetes, and each condition can make the other worse. Office blood pressure bp, outofoffice bp measurement with ambulatory bp monitoring, and selfbp measurement at home are reliable and important data for assessing hypertension. Once a diagnosis of the appropriate form of secondary hypertension is confirmed, tests to distinguish causes and laterality tests to determine the precise. Secondary hypertension has an identifiable cause whereas primary hypertension has no known cause i. Secondary hypertension occurs in only 5 to 10 percent of those with high blood pressure. Secondary hypertension is the presence of a specific condition known to cause hypertension. Recognition, diagnosis and treatment of secondary causes of hypertension lead to good. In such cases, when the root cause is treated, blood pressure usually returns to normal or is significantly lowered. The following are generally not necessary for routine followup of a hypertension diagnosis. The list of secondary causes is well documented, and includes conditions that activate the reninangiotensinaldosterone system ras, ie. 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. How do i investigate suspected secondary hypertension.
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. Severe or resistant hypertension childadolescent worsening of previously stable hypertension malignant hypertension no other risk factors identified and age 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. Know the facts about high blood pressure 1 what is high blood pressure. High blood pressure is said to be present if it is often at or above 14090 mmhg. In most of these cases renal dysfunction resulting from sever chronic kidney disease or renovascular disease is the most common secondary cause. Secondary hypertension or, less commonly, inessential hypertension is a type of hypertension which by definition is caused by an identifiable underlying primary cause. The most common forms of secondary hypertension are as follows. Dermatological complains were promptly managed, a complete cardiovascular risk stratification was performed and.
1163 1371 1466 1141 446 1073 886 908 1679 49 671 1559 47 1156 1375 1247 979 1611 570 889 1480 853 73 809 494 772 1103 737 1271 1155 607 422 1314 1220 1360 433 821