Secondary Hypertension

Overview

Secondary hypertension is hypertension resulting from an identifiable underlying condition or exposure.

The likelihood of a secondary cause depends on age, severity, abruptness of onset, and clinical context.

Common Causes

Important causes include chronic kidney disease, renovascular disease, endocrine disorders, obstructive sleep apnea, and medication or substance effects.

Clinical Clues

Severe or abrupt hypertension, unusual age of onset, resistant hypertension, electrolyte abnormalities, renal dysfunction, or endocrine symptoms should increase suspicion.

Investigation & Management

Investigation should be targeted toward the suspected cause rather than indiscriminate testing.

Blood pressure treatment should occur alongside correction of the underlying disorder whenever possible.

Clinical Pearls