What is Secondary Hypertension?
What is Secondary Hypertension? Secondary hypertension is high blood pressure caused by health problems or other diseases, such as disorders of the blood vessels, heart, kidneys, or endocrine system. Secondary hypertension can also occur because of pregnancy.
Secondary hypertension needs to be addressed early to avoid complications from blood vessel disorders, such as stroke, heart disease, or kidney failure.
Symptoms of Secondary Hypertension
Here are some signs that may indicate a person is exposed to secondary hypertension, including:
- Hypertension resistant. High blood pressure (systolic blood pressure above 140 mm Hg and diastolic above 90 mm Hg) that can not be overcome with a combination of 1 or 2 hypertensive drugs.
- High blood pressure. Systolic blood pressure of more than 180 mm Hg and diastolic over 120 mm / hg.
- There is no history of hypertension in the family.
- A sudden high blood attack before the age of 30 years, or after the age of 55 years.
- The presence of other symptoms associated with secondary causes of hypertension.
Causes of Secondary Hypertension
Only ten percent of cases of hypertension fall into the category of secondary hypertension, the rest is unknown cause hypertension.
Generally the cause of secondary hypertension is associated with increased production of hormones, for example:
- Kidney illness. In the event of impaired blood flow into the kidney, the kidney will release a hormone called renin, which can cause an increase in blood pressure.
- Pheochromocytoma. Tumors in the adrenal glands that produce the hormone epinephrine (adrenaline) and nonepinephrine (nonadrenaline) are excessive.
- Hyperaldosteronism (Conn syndrome). Excess production of aldosterone hormone by the adrenal glands, which can inhibit the removal of salt from the body.
- Hypercortisolism (Cushing’s syndrome). The adrenal glands produce excess hormone cortisol. This condition can also occur in adrenal gland tumors, both malignant and benign.
- Hyperparathyroidism. Increased production of parathyroid hormone (parathormone), which causes increased calcium levels. In people with hyperparathyroidism, there is almost always hypertension. But what causes the hypertension is still unclear.
In addition, there are also some other triggers that can cause secondary hypertension to occur, including:
- Diabetic nephropathy. Complications of diabetes that can damage the renal system work.
- Glomerular disease. Swelling or damage to a small filter called glomeruli that serves to filter waste substances, including salt, from the body.
- Renovascular hypertension. Hypertension that occurs due to narrowing in both arteries that carry blood supply to the kidneys.
- Coarcation of the aorta. Aortic narrowing is a birth defect.
- Pregnancy. Arterial pressure is common during pregnancy and can lead to preeclampsia.
- Sleep disturbance (sleep apnea). Damage to the walls of blood vessels due to the lack of oxygen supply during sleep.
- Obesity. This condition will increase blood flow in the body, triggering more pressure on the artery wall.
- Drugs. Side effects of decongestants, painkillers, contraceptive pills, antidepressants, non-steroidal anti-inflammatory drugs (NSAIDs), methamphetamines and certain herbal remedies may increase blood pressure in the body. Actions such as organ transplants can be one of the triggers of high blood pressure.
Diagnosis of Secondary Hypertension
The diagnosis of secondary hypertension usually can not be done in one meeting. To distinguish secondary and primary hypertension, information on the history of the patient’s illness and family health history is necessary. In physical examination, blood pressure, weight, presence of fluid accumulation, and other marks indicate the presence of the disease.
Examination support that can be done to help determine the diagnosis is as follows:
- Blood tests, to check potassium, glucose, creatinine, sodium, cholesterol, triglycerides, and urea nitrogen (BUN) levels in the blood.
- Urine examination, to check for other health conditions that trigger a rise in blood pressure.
- Ultrasonography, to get a picture of the kidneys and arteries using sound waves.
- Electrocardiogram, to examine the function of the heart, if there is a suspicion that heart disorders are the cause of hypertension.
Treatment of Secondary Hypertension
Secondary hypertension can be treated by overcoming the cause disease. If it can not be treated with medicines, only consider surgery.
Some of the drugs that are usually given for cases of secondary hypertension are:
- Thiazide thuretic diuretic drugs. These drugs work in the kidneys, to help remove salt and water from the body, thus lowering blood volume.
- Calcium channel blockers (calcium channel blockers). The effect of this drug is the occurrence of blood vessel relaxation and slowing heart rate.
- Beta blockers. The work of this drug in lowering blood pressure is to decrease the strength and speed of heart rate and dilate blood vessels.
- Angiotensin converting enzyme inhibitors (ACE inhibitors). This drug works by inhibiting the formation of substances in the body that can cause contractions in the blood vessels.
- Angiotensin II receptor blockers . Slightly different from ACE inhibitors, inhibition is done on the work of substances that can cause contraction of blood vessels, not on the formation.
- Renin inhibitors (direct renin inhibitors). This drug inhibits the action of renin, a hormone produced by the kidney with the function of raising blood pressure.
- Alpha blocker. This drug works by inhibiting the contraction of blood vessels. Alpha inhibitors are commonly used in conjunction with other antihypertensive drugs, especially in hypertension related to the action of adrenal hormones, such as Conn’s syndrome, Cushing’s syndrome, or pheochromocytoma.
Complications of Secondary Hypertension
Complications of secondary hypertension may occur if the treatment of hypertension or disease of the cause is not done properly and thoroughly. Some of the possible complications are:
- Heart failure
- Artery damage
- Narrowing of the arteries in the kidneys
- Widening up to blood vessel pembembungan (aneurysm)
- Narrowing or rupture of blood vessels in the eye
- Decreased brain function
Prevention of Secondary Hypertension
Most of the causes of secondary hypertension are difficult to avoid. However, there are several ways that can be done to reduce the risk of this disease, such as:
- Set the diet. Eat lots of fruits, vegetables, or other low-fat foods. Foods such as potatoes, bananas, avocados and spinach that contain high potassium can be an option. Avoid canned food or frozen food to reduce salt intake. Eating nuts and low-fat milk may also help suppress the symptoms of hypertension.
- Control weight. Obesity is often the main reason someone is attacked by various acute diseases, including secondary hypertension. By keeping your food intake and doing physical activity at least 30 minutes per day can help lower blood pressure in the body.
- Avoid smoking and consuming alcoholic beverages. Smoking can damage the artery walls and clog the bloodstream in the body, while alcoholic drinks can increase blood pressure if consumed in excess.
- Avoid excess stress. Stress can lead to narrowing of blood vessels, increasing heart rate and blood pressure. Stress can be avoided by doing soothing activities, such as meditation, yoga, breathing therapy, exercise, or sleeping adequately.