Causes of Secondary Hypertension

Causes of Secondary Hypertension

1. Renal Causes

   • Chronic kidney disease
   • Renal artery stenosis
   • Glomerulonephritis

2. Endocrine Causes

   • Primary hyperaldosteronism (Conn's syndrome)
   • Cushing's syndrome
   • Pheochromocytoma
   • Hyperthyroidism
   • Acromegaly

3. Cardiovascular Causes

   • Coarctation of the aorta
   • Atherosclerosis

4. Medications and Substances

   • Non-steroidal anti-inflammatory drugs (NSAIDs)
   • Corticosteroids
   • Oral contraceptives
   • Decongestants
   • Stimulants (e.g., amphetamines, cocaine)

5. Lifestyle Factors

   • Excessive alcohol consumption
   • Obesity
   • High sodium intake

6. Sleep Disorders

   • Obstructive sleep apnea

7. Pregnancy-related Causes

   • Gestational hypertension
   • Preeclampsia

8. Other Factors

   • Hypercalcemia
   • Certain tumors (e.g., adrenal tumors)
   • Certain genetic disorders (e.g., Liddle syndrome)

Renal Causes

• Chronic kidney disease leads to impaired regulation of blood pressure.
• Renal artery stenosis occurs due to narrowing of the arteries supplying the kidneys, resulting in increased blood pressure.
• Glomerulonephritis results from kidney inflammation, affecting filtration and contributing to hypertension.

Endocrine Causes

• Primary hyperaldosteronism, also known as Conn's syndrome, is characterized by excessive aldosterone secretion, causing sodium retention and increased blood pressure.
• Cushing's syndrome involves excess cortisol, leading to hypertension among other metabolic changes.
• Pheochromocytoma is a rare tumor of the adrenal gland that secretes catecholamines, causing sporadic hypertension.
• Hyperthyroidism accelerates metabolism and can lead to increased heart rate and blood pressure.
• Acromegaly, caused by excessive growth hormone, can result in elevated blood pressure due to metabolic changes.

Cardiovascular Causes

• Coarctation of the aorta is a congenital condition where the aorta is narrowed, leading to elevated blood pressure in upper body parts.
• Atherosclerosis involves plaque buildup in arteries, increasing resistance and leading to hypertension.

Medications and Substances

• NSAIDs can induce sodium retention and increase blood pressure.
• Corticosteroids may cause fluid retention and elevated blood pressure.
• Oral contraceptives can lead to hypertension, particularly in predisposed women.
• Decongestants can raise blood pressure by causing vasoconstriction.
• Stimulants such as amphetamines and cocaine directly increase cardiac output and vascular resistance.

Lifestyle Factors

• Excessive alcohol consumption can lead to high blood pressure through various physiological mechanisms.
• Obesity is a major risk factor, associating with insulin resistance and increased blood volume.
• High sodium intake contributes to fluid retention and increased blood pressure.

Sleep Disorders

• Obstructive sleep apnea is associated with episodes of hypoxia that can lead to sympathetic overactivity and increased blood pressure.

Pregnancy-related Causes

• Gestational hypertension occurs during pregnancy, often resolving post-delivery.
• Preeclampsia is a serious condition characterized by hypertension and proteinuria, requiring careful monitoring.

Other Factors

• Hypercalcemia can stimulate vascular smooth muscle contraction, leading to higher blood pressure.
• Certain tumors, particularly adrenal tumors, may secrete hormones that elevate blood pressure.
• Genetic disorders like Liddle syndrome involve abnormal sodium handling, causing hypertension.

This quiz covers the various causes of secondary hypertension, including renal, endocrine, cardiovascular factors, and medications. It also addresses lifestyle impacts, sleep disorders, pregnancy-related causes, and other contributing factors. Test your understanding of these complex interactions that can lead to hypertension.