secondary hypertension

If primary hypertension is many small settings drifting together, secondary hypertension is a single faulty part driving the gauge up. It is high blood pressure caused by a specific, identifiable underlying condition, which means that finding and treating that cause can sometimes cure or dramatically improve the pressure.

Common culprits include narrowed renal arteries, kidney disease, sleep apnea, and hormone-producing disorders such as excess aldosterone (primary aldosteronism), thyroid disease, or rare adrenal tumors. Certain medications and substances, including some decongestants, oral contraceptives, NSAIDs, excess alcohol, and stimulants, can also raise pressure.

Clues that prompt a search for a secondary cause include hypertension appearing before age 30 or after 65, very high or suddenly worsening pressure, blood pressure that resists three or more medications, or specific signs such as low potassium or an abdominal bruit. It accounts for a small minority of all hypertension, but identifying it matters because the treatment is often quite different from routine blood-pressure pills.