6.2 Secondary Hypertension

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Secondary hypertension is a type of hypertension which results from an identifiable underlying cause. It affects only 5% to 10% of hypertensive patients. The most common types of secondary hypertension in adults are renal parenchymal diseases, renovascular hypertension, primary aldosteronism, chronic sleep apnea, and substance/drug induced. Secondary causes of hypertension and their features are given in Table 9.

Additional investigations of patients for secondary causes of hypertension are particularly appropriate in the following groups:

• Patients with early onset hypertension under 30 years of age in particular in the absence of hypertension risk factors
• Patients with hypertension urgency or emergency
• Patients resistant to antihypertensive therapy
• Patients with abnormal renal function, proteinuria, or hematuria
• Patients with hypokalemia without diuretic therapy
• BP begins to increase for uncertain reasons after being well controlled.
• Onset of hypertension is sudden.

Treatment of secondary hypertension depends on the causes of high blood pressure.