Approach to the diagnosis of secondary hypertension in adults (2022)

SUMMARY

Presentations that should raise suspicion of secondary hypertension include early-onset, severe or resistant hypertension. A suggestive family history or clinical clues can point to a specific secondary cause.

The most common causes and associations are renal disease, primary aldosteronism and obstructive sleep apnoea. Medicines, illicit substances and alcohol may also be responsible.

The assessment of patients begins with history taking and examination, to look for clinical clues. Laboratory tests include electrolytes, urea, creatinine and the aldosterone:renin ratio, urinalysis and the urine albumin:creatinine ratio. Abnormal results should prompt further investigation.

Initial testing for primary aldosteronism is best done before starting potentially interfering antihypertensive drugs. If the patient is already taking interfering antihypertensive drugs that cannot be stopped, the interpretation of the aldosterone:renin ratio must consider the presence of those drugs. Specialist advice can be sought if needed.

Introduction

Secondary hypertension occurs in approximately 10% of adults with hypertension.1 There are many possible causes (Table 1). Identifying and treating the cause can potentially cure or markedly improve hypertension and reduce the associated cardiovascular risk.1,2

The history and examination may raise suspicion of secondary hypertension. It is important to remember that drugs can cause hypertension. Laboratory tests can help to identify other causes.

Table 1 - Laboratory tests in the initial investigation of secondary hypertension

Cause*

Prevalence in unselected hypertensive patients

Clinical clues

Laboratory tests

Renovascular disease†

5%

Acute worsening of renal function after starting an ACE inhibitor or angiotensin receptor antagonist, flash pulmonary oedema, early-onset hypertension in a female, abdominal bruit

Electrolytes and creatinine with eGFR

Urinalysis

Urine albumin:creatinine ratio

Renal parenchymal disease†

1%

Haematuria, proteinuria, history of recurrent urinary tract infections or obstruction, family history, polycystic kidneys, abdominal mass

Electrolytes and creatinine with eGFR

Urinalysis

Urine albumin:creatinine ratio

Primary aldosteronism

8%

Hypokalaemia

Aldosterone:renin ratio

Drugs, alcohol and other substances

2%

Drug history, NSAIDs, SNRIs, decongestants, oral contraceptives, bupropion, ciclosporin, tacrolimus, cocaine, amphetamines, caffeine, nicotine, alcohol, liquorice, some herbal supplements

Cushing’s syndrome

<1%

Striae (purplish-red), proximal muscle wasting, easy bruising, thin skin, rapid weight gain, central adiposity, moon facies, buffalo hump, pathologic fracture, diabetes mellitus

Late night salivary cortisol on two occasions

Free cortisol in 24-hour urine on two occasions

(Video) SECONDARY HYPERTENSION DIAGNOSIS, WORKUP REVIEW, CAUSES, SECONDARY ARTERIAL HYPERTENSION

1 mg overnight dexamethasone suppression test

Measuring a morning or random serum cortisol is not recommended owing to a low sensitivity and specificity for Cushing’s syndrome

Phaeochromocytoma/ paraganglioma

<1%

Paroxysms or ‘spells’: headache, palpitations, sweating, pallor, labile blood pressure

Plasma metanephrines

Aortic coarctation †

<1%

Well-developed upper body, hypertension confined to the upper limbs, systolic murmur

Obstructive sleep apnoea ‡

25%

Snoring, daytime somnolence, morning headache

eGFR estimated glomerular filtration rate
NSAIDs non-steroidal anti-inflammatory drugs
SNRIs serotonin noradrenaline reuptake inhibitors

* Other rare causes of secondary hypertension include acromegaly, thyroid dysfunction and primary hyperparathyroidism.

† Laboratory tests should be complemented by imaging.

‡ Obstructive sleep apnoea has a very strong and important association, but may not be a cause of secondary hypertension.

Who should be assessed for secondary hypertension?

International and local guidelines differ in their recommendations and prescriptiveness in relation to screening for secondary causes of hypertension. In general, patients with hypertension and any of the following characteristics should be screened:1,3

  • age of onset less than 40 years
  • abrupt onset of hypertension
  • abrupt worsening of hypertension despite previously good control
  • hypertensive urgency or emergency
  • resistant hypertension (blood pressure≥140/90 mmHg despite the consistent use of three antihypertensive drugs including a diuretic, or a need for four or more drugs to control the blood pressure)
  • target organ damage disproportionate to the degree of hypertension
  • family history of early-onset hypertension, stroke before the age of 40 years, or primary aldosteronism
  • clinical clues
    • hypokalaemia (may occur in primary aldosteronism)
    • higher elevation than expected (>20%) of serum creatinine after starting an ACE inhibitor or angiotensin receptor antagonist (may suggest renovascular hypertension)
    • paroxysmal hypertension or episodes suggestive of catecholamine excess (suggestive of phaeochromocytoma).

All patients suspected of having secondary hypertension should be screened for the common causes and associations. These include renal disease (parenchymal or renovascular), primary aldosteronism, medicines, illicit substances, alcohol and obstructive sleep apnoea. Other, less prevalent causes should only be investigated if there is strong clinical suspicion of a particular disorder, such as coarctation of the aorta. It is important to remember that a lack of adherence to antihypertensive treatment can cause persistent hypertension.

Initial tests for primary aldosteronism

Patients with primary aldosteronism have a higher risk of cardiovascular morbidity and mortality than other age-, sex- and blood pressure-matched patients.3 Although testing for primary aldosteronism has not been directly linked with mortality benefits, treating primary aldosteronism surgically (by unilateral adrenalectomy) or with specific mineralocorticoid blockade may improve long-term cardiovascular outcomes.4

Hypertension is often the only sign of primary aldosteronism. Most patients do not present with the classical feature of hypokalaemia.

Screening for primary aldosteronism is straightforward if the patient has not started antihypertensive therapy. This involves a blood test, in an unfasted patient who has been ambulatory for at least two hours. Itmeasures aldosterone and renin, allowing calculation of the aldosterone:renin ratio.3 This ratio is important as some patients with primary aldosteronism will have normal concentrations of aldosterone. As hypokalaemia can cause a false-negative ratio, potassium should be concurrently measured.

Reference intervals and screening thresholds for aldosterone, renin and their ratio vary according to the laboratory’s method of measurement (laboratories may measure either direct renin or plasma renin activity). The ratio should be interpreted in the context of the absolute values for aldosterone and renin. For example, a raised ratio due to a very high aldosterone with a non- suppressed renin concentration may be more suggestive of secondary hyperaldosteronism due to diuretic use or other causes. The ratio could also be raised because of a very low renin, even if the aldosterone concentration is not as high as is typically seen in primary aldosteronism.

The finding of an increased aldosterone:renin ratio not explained by interfering antihypertensives and confirmed on more than one occasion should prompt referral to a physician with an interest in hypertension, for consideration of confirmatory dynamic testing and specific treatment.

Effect of antihypertensive drugs

Although most antihypertensives affect the plasma concentrations of aldosterone, renin and their ratio (see Fig. and Table 2), additional indications may prevent the suspension of some drugs, such as when a beta blocker is also being used to control an arrhythmia. Initial testing therefore ofte needs to take place while the patient is still taking interfering antihypertensives. Interpreting an aldosterone:renin ratio while a patient is taking interfering antihypertensives can be difficult. Documenting the patient’s antihypertensive drugs on the request form will assist the pathologist’s analysis.

Fig. - Effects of interfering drugs on aldosterone and renin

Approach to the diagnosis of secondary hypertension in adults (1)

ARR aldosterone:renin ratio

Table 2 - Factors that may lead to false-positive or false-negative aldosterone:renin ratio results

Factor

Effect on aldosterone plasma concentration

Effect on renin concentration

Effect on aldosterone:renin ratio

(Video) Secondary Hypertension; Causes and their pathophysiology.

Drugs*

Beta adrenergic blockers

↓↓

↑­ (FP)

Central agonists (e.g. clonidine, alpha methyldopa)

↓↓

↑­ (FP)

Non-steroidal anti-inflammatory drugs


↓↓

­↑ (FP)

Potassium wasting diuretics

→ ↑

­ ­↑↑

↑­ (FN)

Potassium sparing diuretics

­↑

­ ­↑↑

↓ (FN)

ACE inhibitors

­ ­↑↑

↓ (FN)

Angiotensin receptor antagonist

­ ­↑↑

↓ (FN)

Calcium channel blockers (dihydropyridines)

→ ↓


↓ (FN)

Renin inhibitors

↓ ­↑

↑­ (FP)

↓ (FN)

Potassium status

Hypokalaemia


→ ↑

↓ (FN)

Potassium loading


→ ↓

­↑

Dietary sodium

Sodium restriction

↑­

↑↑

(Video) Evaluation of Secondary Hypertension | Harvard Medical School Continuing Education

­ ↑ (FN)

Sodium loading


↓↓

­ ↑ (FP)

Advancing age


↓↓

­ ↑(FP)

Premenopausal women (vs males)

→ ↑­


↑­ (FP)

Other conditions

Renal impairment


↑­ (FP)

PHA-2


↑­ (FP)

Pregnancy

­↑

­ ­↑↑

↓ (FN)

Renovascular hypertension

­↑

­ ­↑↑

↓ (FN)

Malignant hypertension

­↑

­ ↑↑

↓ (FN)

FN false negative, FP false positive
↓decreases effect,↑ increases effect,→ has no effect

PHA-2 pseudohypoaldosteronism type 2 (familial hypertension and hyperkalaemia with normal glomerular filtration rate)

* Renin inhibitors lower plasma renin activity, but raise direct renin concentration. This would be expected to result in false-positive aldosterone:renin ratios for renin measured as plasma renin activity and false negatives for renin measured as direct renin concentration.

† In premenopausal, ovulating women, plasma aldosterone concentrations measured during the menses or the proliferative phase of the menstrual cycle are similar to those of men but rise briskly in the luteal phase. Because renin concentrations are lower, the aldosterone:renin ratio is higher than in men for all phases of the cycle, but especially during the luteal phase during which aldosterone rises to a greater extent than renin. False positives can occur during the luteal phase, but only if renin is measured as direct renin concentration and not plasma renin activity. In preliminary studies, some investigations have found false positives on the current cut-offs for women in the luteal phase. Accordingly, it would seem sensible to screen women at risk in the follicular phase, if practicable.

Source: adapted from reference 3

A suppressed renin, high aldosterone and raised ratio in a patient taking an ACE inhibitor alone (expectedto increase renin and decrease aldosterone) would be suspicious for primary aldosteronism. However, a normal ratio in the same patient would not exclude primary aldosteronism, as it may be a false negative. On the other hand, beta blockers decrease renin concentrations. A patient taking a beta blocker who has a non-suppressed renin concentration probably does not have primary aldosteronism, but a suppressed renin and a raised ratio could be a false-positive result.

Sometimes, substitution of interfering antihypertensives with non-interfering antihypertensives is required to obtain a reliable ratio. This is also important for further confirmatory testing that may follow initial screening. Table 3 shows non-interfering antihypertensives that may be used during the workup to control blood pressure.5 As adjusting the antihypertensive regimen can be a lengthy process and is not without risks, it should only be pursued for patients expected to benefit from the diagnosis and treatment of primary aldosteronism. A discussion with a physician with a special interest inhypertension should be considered, and the patient should understand why changes to their treatment are being proposed.

Table 3 - Drugs that do not interfere with calculating the aldosterone:renin ratio5

Starting dose

Maximum dose

Sustained-release verapamil*

180 mg daily

240 mg daily

Moxonidine

200 micrograms once at night

200 micrograms twice daily after two weeks

Prazosin

0.5 mg twice daily

5 mg three times a day

Hydralazine hydrochloride

12.5 mg twice daily

50 mg three times a day

* Administration of verapamil as two divided doses may provide better coverage over 24 hours, if necessary. Doses higher than 240 mg daily may be used, but are often limited by adverse effects, therefore addition of a second drug is advised before increasing the verapamil dose.

(Video) An Approach to Hypertension in Older Adults

When adjusting the antihypertensive regimen, drugs are usually ceased one at a time at a rateof one per week, or more slowly if there is a needto maintain blood pressure control. Diuretics including spironolactone are stopped first, as they require a washout of at least four weeks. Other antihypertensives need to be ceased for a minimum of two weeks before testing.3 Blood pressure should be monitored at least twice a week. Home blood pressure monitoring can be helpful for selected patients. Non-interfering antihypertensives, if required, may be introduced and up-titrated one at a time. The target blood pressure may be individualised based on the patient’s previous blood pressure, their age and the duration of hypertension. This blood pressure may be higher than the usual target for the prevention of cardiovascular disease, given that these drug substitutions are only temporary.

Patients should be informed of the symptoms of a hypertensive emergency, what a safe blood pressureis and how to seek medical attention if their blood pressure exceeds this. Provide counselling about the adverse effects, the frequency of dosing for the non-interfering antihypertensives, and the precautions for driving.

Conclusion

Identifying secondary hypertension presents an opportunity to modify a patient’s cardiovascular risk profile beyond what is achievable by antihypertensive therapy alone. Renal disease and primary aldosteronism are common causes.

A methodical approach to identifying the cause is necessary and must take into account the drugs being used by the patient. Advice on test selection and patient preparation to optimise the value of initial investigations can be provided by a chemical pathologist or hypertension specialist. Patients who have abnormal results will require further investigations to confirm the cause.

Conflicts of interest: none declared

This article is peer-reviewed.

Australian Prescriber welcomes Feedback.

References

  1. Whelton PK, Carey RM, Aronow WS, Casey DE Jr, Collins KJ, Dennison Himmelfarb C, et al. 2017 ACC/AHA/AAPA/ABC/ ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation 2018;138:e484-594.
  2. Williams B, Mancia G, Spiering W, Agabiti Rosei E, Azizi M, Burnier M, et al. 2018 Practice guidelines for the management of arterial hypertension of the European Society of Cardiology and the European Society of Hypertension. Blood Press 2018;27:314-40.
  3. Funder JW, Carey RM, Mantero F, Murad MH, Reincke M, Shibata H, et al. The management of primary aldosteronism: case detection, diagnosis, and treatment: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 2016;101:1889-916.
  4. Hundemer GL. Primary aldosteronism: cardiovascular outcomes pre- and post-treatment. Curr Cardiol Rep 2019;21:93.
  5. Gurgenci T, Geraghty S, Wolley M, Yang J. Screening for primary aldosteronism: How to adjust existing antihypertensive medications to avoid diagnostic errors. Aust J Gen Pract 2020;49:127-31.

FAQs

What is the commonest cause of secondary hypertension in adults? ›

Causes
  • Diabetes complications (diabetic nephropathy). Diabetes can damage the kidneys' filtering system, which can lead to high blood pressure.
  • Polycystic kidney disease. ...
  • Glomerular disease. ...
  • Renovascular hypertension.
9 Aug 2022

Who should be evaluated for secondary hypertension? ›

It should be suspected in those who develop hypertension after 50 years of age, have known atherosclerosis elsewhere, have unexplained renal insufficiency, or have a rapid deterioration in kidney function (i.e., an increase in the serum creatinine level of at least 0.5 to 1 mg per dL [44.20 to 88.40 μmol per L]) when ...

Can you identify 2/3 causes of secondary hypertension? ›

Secondary hypertension is high blood pressure caused by another condition or disease. Conditions that may cause secondary hypertension include kidney disease, adrenal disease, thyroid problems and obstructive sleep apnea.

What diagnostic tests are performed to diagnose hypertension? ›

A blood pressure test is easy and painless and can be done in the provider's office or clinic. The provider uses a gauge, stethoscope, or electronic sensor and a blood pressure cuff to measure your blood pressure.

What are the 5 causes of secondary hypertension? ›

This section briefly discusses the management of the more common causes of secondary hypertension, viz: renal parenchymal disease, renovascular hypertension, primary hyperaldosteronism, obstructive sleep apnea, drug-induced hypertension, and pregnancy.

What medications can cause secondary hypertension? ›

Systemic corticosteroids such as dexamethasone, fludrocortisone, methylprednisolone, prednisone, and prednisolone may cause an elevated blood pressure (4). The increase in blood pressure is dose dependent. Alternative ways of administration of these drugs such as inhalation or topical use should be considered.

When do you check for secondary hypertension? ›

Secondary hypertension should be considered in the presence of suggestive signs and symptoms such as severe or resistant hypertension, onset before 30 years of age (especially before puberty), malignant or accelerated hypertension, and an acute rise in blood pressure from previously stable readings (Table 1).

What is diagnosis code for secondary hypertension? ›

9: Secondary hypertension, unspecified.

How do you test for secondary pulmonary hypertension? ›

Blood and imaging tests done to help diagnose pulmonary hypertension may include:
  1. Blood tests. Blood tests can help determine the cause of pulmonary hypertension or detect signs of complications.
  2. Chest X-ray. ...
  3. Electrocardiogram (ECG). ...
  4. Echocardiogram. ...
  5. Right heart catheterization.
13 Apr 2022

What is the difference between hypertension and secondary hypertension? ›

The difference between primary hypertension and secondary hypertension is the causes related to each. Primary hypertension does not have a definitive cause, while secondary hypertension has a known cause. Both primary and secondary hypertension result in high blood pressure.

What is another name for secondary hypertension? ›

Secondary hypertension (or, less commonly, inessential hypertension) is a type of hypertension which by definition is caused by an identifiable underlying primary cause.

Can stress cause secondary hypertension? ›

Stress can cause hypertension through repeated blood pressure elevations as well as by stimulation of the nervous system to produce large amounts of vasoconstricting hormones that increase blood pressure.

What is the gold standard for diagnosing hypertension? ›

ABPM is currently considered the gold standard for the correct diagnosis of hypertension on the grounds that the ambulatory BP provides extensive information on several BP parameters other than the average BP, including BP variability, the morning BP surge, BP load, and the nocturnal fall in BP.

Which of the following is used to diagnose hypertension in adults? ›

Your doctor can diagnose hypertension by checking your blood pressure. It is a very simple test that takes only a few minutes. Usually an inflatable upper arm cuff with a gauge is used. Your doctor or other medical professional will slide the blood pressure cuff to just above your elbow on your bare arm.

How is secondary hypertension treated? ›

Typically, medication is prescribed to treat the condition that caused the hypertension. Some people may also need to take high blood pressure medication until the underlying condition is treated successfully. For many, their high blood pressure can be cured once the medical condition is properly treated.

What are the risk factors for secondary hypertension? ›

Risk factors for secondary hypertension
  • Use of oral contraceptives or corticosteroids.
  • Problems with your adrenal or thyroid glands.
  • Hormonal disorders or pregnancy.
  • A congenital defect of the aorta in your heart called coarctation.
  • Kidney disease, or insufficient blood flow to the kidneys due to arterial blockage.

What is the pathophysiology of secondary hypertension? ›

Emotional stress leads to activation of the sympathetic nervous system, which causes increased release of norepinephrine from sympathetic nerves in the heart and blood vessels, leading to increased cardiac output and increased systemic vascular resistance.

What percentage of hypertension is secondary hypertension? ›

Secondary hypertension is a common cause of hypertension in adults, occurring in about 10% of hypertensive patients. Failure to recognise secondary causes can lead to resistant hypertension, cardiovascular complications or complications of the underlying condition.

What is the first choice drug for hypertension? ›

First-line (first choice) options include these blood pressure medication names: Thiazide diuretics, calcium channel blockers and ― for people who have kidney disease and heart failure ― angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs).

Which drug should be avoided in hypertension? ›

Certain pain and anti-inflammatory medications can cause you to retain water, creating kidney problems and increasing your blood pressure. Examples include: Indomethacin (Indocin, Tyvorbex) Over-the-counter drugs such as aspirin, naproxen sodium (Aleve) and ibuprofen (Advil, Motrin IB, others)

What is the blood pressure of patient having a Stage 2 hypertension? ›

Stage 2 hypertension is defined as a blood pressure at or above 140/90 mmHg. Having hypertension puts you at risk for heart disease and stroke, which are leading causes of death in the United States. In 2020, more than 670,000 deaths in the United States had hypertension as a primary or contributing cause.

What is a secondary diagnosis example? ›

The diagnoses for DM, COPD, and CAD would be coded as secondary diagnoses because they will require treatment and monitoring during the patient stay. The acute STEMI will also be coded as a secondary diagnosis because it developed after admission.

What are the two 2 types of classification of hypertension? ›

There are two primary hypertension types. For 95 percent of people with high blood pressure, the cause of their hypertension is unknown — this is called essential, or primary, hypertension. When a cause can be found, the condition is called secondary hypertension.

What is a differential diagnosis for hypertension? ›

Differential Diagnosis

Hyperaldosteronism, coarctation of the aorta, renal artery stenosis, chronic kidney disease, and aortic valve disease should always be kept in the differential.

What is the best test for pulmonary hypertension? ›

Pulmonary hypertension is diagnosed primarily with an echocardiogram, which is an ultrasound examination of the heart. The echocardiogram measures the heart's size and shape by using sound waves to create an image of the heart and can estimate the pulmonary artery pressure.

Does chest xray show pulmonary hypertension? ›

Pulmonary artery hypertension (PAH) is difficult to diagnose because of its nonspecific symptoms. Although echocardiography can reliably and rapidly recognize the presence of pulmonary hypertension, chest X ray (CXR) is more widely used because of its availability.

Do most people with hypertension have secondary hypertension? ›

Secondary hypertension is rare, affecting about only 5% of people with chronic high blood pressure. While many different underlying conditions can cause secondary hypertension, some of the more common include: Kidney disease. Adrenal disease.

What is the difference between stage 1 and stage 2 hypertension? ›

1 The updated guideline redefined hypertension as a systolic blood pressure measurement of 130 mmHg and greater or diastolic blood pressure measurement of 80 mmHg and beyond. 1 As a result, patients with systolic BP measurements greater than or equal to 140/90 mmHg are now considered to have stage 2 hypertension.

Can lack of sleep cause high blood pressure? ›

The less you sleep, the higher your blood pressure may go. People who sleep six hours or less may have steeper increases in blood pressure. If you already have high blood pressure, not sleeping well may make your blood pressure worse.

Can overthinking cause high blood pressure? ›

Your body produces a surge of hormones when you're in a stressful situation. These hormones temporarily increase your blood pressure by causing your heart to beat faster and your blood vessels to narrow. There's no proof that stress by itself causes long-term high blood pressure.

Does anxiety raise systolic or diastolic BP? ›

Can anxiety cause high diastolic blood pressure? A lack of research suggests that anxiety triggers increases in diastolic blood pressure alone. However, anxiety may elevate diastolic blood pressure in some people.

What is the commonest cause of hypertension? ›

Stress-related habits such as eating more, using tobacco or drinking alcohol can lead to further increases in blood pressure. Certain chronic conditions. Kidney disease, diabetes and sleep apnea are some of the conditions that can lead to high blood pressure.

What are 3 leading causes of hypertension? ›

Being overweight or obese. Lack of physical activity. Too much salt in the diet. Too much alcohol consumption (more than 1 to 2 drinks per day)

What are three common causes for hypertension? ›

Things that can increase your risk of getting high blood pressure
  • are overweight.
  • eat too much salt and do not eat enough fruit and vegetables.
  • do not do enough exercise.
  • drink too much alcohol or coffee (or other caffeine-based drinks)
  • smoke.
  • do not get much sleep or have disturbed sleep.
  • are over 65.

What is the commonest cause of primary hypertension? ›

Primary Hypertension (Formerly Known as Essential Hypertension) Essential (primary) hypertension occurs when you have abnormally high blood pressure that's not the result of a medical condition. This form of high blood pressure is often due to obesity, family history and an unhealthy diet.

What are 4 risk factors for hypertension? ›

What are the risk factors for hypertension? Modifiable risk factors include unhealthy diets (excessive salt consumption, a diet high in saturated fat and trans fats, low intake of fruits and vegetables), physical inactivity, consumption of tobacco and alcohol, and being overweight or obese.

What are 4 major causes of high blood pressure? ›

Common factors that can lead to high blood pressure include:
  • A diet high in salt, fat, and/or cholesterol.
  • Chronic conditions such as kidney and hormone problems, diabetes, and high cholesterol.
  • Family history, especially if your parents or other close relatives have high blood pressure.
  • Lack of physical activity.
30 Apr 2020

What are 5 symptoms of hypertension? ›

Symptoms of High Blood Pressure
  • Blurry or double vision.
  • Lightheadedness/Fainting.
  • Fatigue.
  • Headache.
  • Heart palpitations.
  • Nosebleeds.
  • Shortness of breath.
  • Nausea and/or vomiting.

What are the 11 risk factors for hypertension? ›

If you have one of these conditions, you can take steps to manage it and lower your risk for high blood pressure.
  • Elevated Blood Pressure. ...
  • Diabetes. ...
  • Unhealthy Diet. ...
  • Physical Inactivity. ...
  • Obesity. ...
  • Too Much Alcohol. ...
  • Tobacco Use. ...
  • Genetics and Family History.
24 Feb 2020

What is normal blood pressure for a 60 year old? ›

Normal blood pressure for most adults is defined as a systolic pressure of less than 120 and a diastolic pressure of less than 80.

What is normal blood pressure for a 70 year old? ›

Elderly blood pressure range for men and women

The American College of Cardiology (ACC) and the American Heart Association (AHA) updated their guidelines in 2017 to recommend men and women who are 65 or older aim for a blood pressure lower than 130/80 mm Hg.

What are 3 ways to treat hypertension? ›

Advertisement
  1. Lose extra pounds and watch your waistline. Blood pressure often increases as weight increases. ...
  2. Exercise regularly. ...
  3. Eat a healthy diet. ...
  4. Reduce salt (sodium) in your diet. ...
  5. Limit alcohol. ...
  6. Quit smoking. ...
  7. Get a good night's sleep. ...
  8. Reduce stress.

Can lack of sleep cause high blood pressure? ›

The less you sleep, the higher your blood pressure may go. People who sleep six hours or less may have steeper increases in blood pressure. If you already have high blood pressure, not sleeping well may make your blood pressure worse.

What 3 things can prevent hypertension? ›

High blood pressure can often be prevented or reduced by eating healthily, maintaining a healthy weight, taking regular exercise, drinking alcohol in moderation and not smoking.

What are the 4 types of hypertension? ›

White-coat hypertension and labile hypertension are two such examples.
...
Isolated systolic hypertension, malignant hypertension, and resistant hypertension are all recognized hypertension types with specific diagnostic criteria.
  • Isolated systolic hypertension. ...
  • Malignant hypertension. ...
  • Resistant hypertension.
18 Nov 2009

What is the difference between essential hypertension and secondary hypertension? ›

The difference between primary hypertension and secondary hypertension is the causes related to each. Primary hypertension does not have a definitive cause, while secondary hypertension has a known cause. Both primary and secondary hypertension result in high blood pressure.

Can secondary hypertension be cured? ›

Treatment for secondary hypertension involves treating the medical condition that's causing it with medications or surgery. Once the condition is treated, blood pressure might decrease or return to normal. Treatment might require continuing to take blood pressure medication, as well.

Videos

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3. Dr. V T Shah - Secondary Hypertension - Stepwise Approach
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