Causes of secondary hypertension, symptoms and how to deal with it

High blood pressure or hypertension is a common health condition. Based on 2018 Riskesdas data, 34.1 percent of Indonesians suffer from high blood pressure. Most of the hypertension that occurs due to uncertain causes, is called essential hypertension or primary hypertension. However, high blood pressure can also occur due to other factors, called secondary hypertension. What causes this type of hypertension and how is it treated?

What is secondary hypertension?

Secondary hypertension is a type of high blood pressure caused by certain diseases or health conditions. This condition usually occurs due to several diseases that attack the kidneys, arteries, or endocrine system. Secondary hypertension can also occur during pregnancy.

This type of hypertension is rare, when compared to primary hypertension. Secondary hypertension only occurs in 5-10 percent of people with high blood pressure. Meanwhile, cases of primary hypertension can reach 90 percent of sufferers.

High blood pressure due to secondary hypertension can be treated by treating the causative factor. This treatment is also at the same time to reduce the risk of complications of hypertension.

What are the causes of secondary hypertension?

Secondary hypertension is caused by certain diseases or health conditions. Here are some of them:

1. Kidney disease

Kidney disease is a malfunctioning of the kidneys. This condition can cause high blood pressure when there is narrowing of one or two of the arteries leading to the kidneys, which is known as stenosis. This can cause the blood supply to the kidneys to decrease and this condition triggers an increase in the production of a hormone called renin.

Excess levels of renin can stimulate the production of certain compounds, such as the angiotensin II protein molecule. The compound can increase blood pressure.

In addition, several other kidney problems that can cause hypertension include:

Polycystic kidney disease, or the presence of a cyst in the kidney that prevents the kidneys from working normally, which can increase blood pressure.
Glomerulonephritis, which is inflammation of the glomeruli that can interfere with the process of filtering waste from sodium in the body, which can lead to high blood pressure.

2. Diseases of the adrenal glands

The adrenal glands are organs that are located on top of the kidneys and play a role in the production of hormones in the body. If there is a problem with these glands, the hormones in the body become imbalanced and lead to health problems, such as:

Pheochromocytoma: a tumor in the adrenal glands that overproduces the hormones epinephrine and norepinephrine, causing blood pressure to rise
Conn's syndrome or aldosteronism: a condition when the body produces too much of the hormone aldosterone, so the body can't get rid of salt properly and blood pressure becomes high.
Cushing's syndrome: resulting in excessive production of the hormone cortisol, so that blood pressure and carbohydrate metabolism in the body are disturbed.

3. Hyperparathyroidism

Hyperparatioridism can also cause secondary hypertension. In this condition, the parathyroid glands, which are in the neck, overproduce the parathormone hormone. This hormone has the potential to trigger an increase in calcium levels in the blood. As for this, it can cause an increase in blood pressure.

4. Thyroid disorders

Disorders that occur in the thyroid gland, such as hypothyroidism or hyperthyroidism, can also cause high blood pressure due to hormonal imbalances in the body.

5. Coarctation of the aorta

Coarctation of the aorta is a narrowing that occurs in the aortic vessel. If this condition occurs, blood flow can be interrupted and the pressure rises.

6. Sleep apnea obstructive

Sleep apnea is a condition when your breath stops briefly during sleep. This condition can cause you to lack oxygen which can damage blood vessels. Meanwhile, if it continues to happen, your blood pressure can rise.

7. Consumption of certain drugs

Several types of drugs can also trigger secondary hypertension, such as:

Contraceptive drugs.
Drug non-steroidal anti-inflammatory agent (NSAID).
Diet pills.
Antidepressant drugs.
Immune system suppressant drugs.
Decongestant drugs.
Chemotherapy drugs.

Apart from some of the conditions above, secondary hypertension can also be triggered by several other health conditions which include:

Excess weight (obesity).
Insulin resistance in the body, which is one of the causes of diabetes.
Increased blood lipid levels (dyslipidemia).

What are the signs and symptoms of secondary hypertension?

Just like primary hypertension, secondary hypertension has no specific symptoms. If there are symptoms or signs that you feel, generally it occurs because your blood pressure has risen very high or because of another disease that you are suffering from, which causes high blood pressure. Therefore, the symptoms of secondary hypertension generally vary, depending on the disease or health condition that is the main cause of hypertension.

Some of the most common signs and symptoms are:

Headache.
Excessive sweating.
The heart beats faster.
Unreasonable weight gain, or even dropping dramatically.
The body feels weak.
Worry.

In some cases, sufferers may also experience chest pain, shortness of breath, or nosebleeds. However, generally these symptoms only appear when this condition has entered a more severe stage. Immediately consult a doctor if this happens to you.

Apart from those listed above, there may be other signs and symptoms that you are experiencing. If you have concerns about certain symptoms, consult a doctor immediately.

How do doctors diagnose secondary hypertension?

Blood pressure can be said to be high when it is at certain systolic and diastolic numbers, which reaches 140/90 mmHg. The normal blood pressure is below 120/80 mmHg. If you are between these two numbers, you are classified as having prehypertension.

To be able to diagnose hypertension, the doctor will measure your blood pressure with a blood pressure measuring device. The doctor may check your blood pressure several times, including with an ambulatory blood pressure gauge, to confirm the diagnosis.

However, before diagnosing whether you have secondary hypertension or not, your doctor will usually find out if you have certain factors, such as:

Age under 30 years with hypertension.
There is a history of resistant hypertension (hypertension does not improve even though it has been treated with antihypertensive drugs).
Not suffering from obesity.
None of the family members suffer from hypertension.
There are signs and symptoms of other diseases.

In addition, your doctor may recommend other tests. Some of the tests that may be done are:

Blood test.
Blood urea level test (BUN test).
Urine test.
Kidney ultrasound.
CT or MRI scan.
EKG or heart record.

How is secondary hypertension treated?

Secondary hypertension can be overcome by treating certain diseases or health conditions that cause it. Once the disease is properly treated, your blood pressure can drop and even return to normal.

Treatment for secondary hypertension varies, depending on the disease you have. If a tumor is found, surgery or surgery may be performed. Therefore, always consult with your doctor about the right treatment for your condition.

Apart from these medications, lifestyle changes are also needed to control blood pressure, such as regular exercise, quitting smoking, limiting alcohol, a hypertensive diet, maintaining body weight, and managing stress. It is also necessary to prevent your hypertension from getting worse.