Causes of Secondary Hypertension: A Guideline Topline for Primary Care
Obstructive sleep apnea is a cause of secondary hypertension in up to 50% of cases; more common causes here, from the 2017 ACC/AHA hypertension guidelines.
In patients with secondary hypertension, correct identification and treatment of the cause may lead to cure or to significant improvement in blood pressure control, according to the 2017 ACC/AHA clinical guidelines on detection and treatment of hypertension in adults. There is often a strong association with clinical findings or groups of findings that point to a specific disorder as well.
Following is a topline look at conditions cited in the 2017 guidelines commonly linked to secondary hypertension; included are clinical indications to look for, signs to note on physical examination, screening tests to consider, and confirmatory tests that may be needed.
Renal parenchymal disease is a cause of secondary hypertension 1%-2% of the time.
Renovascular disease is a cause of secondary hypertension 5% to 34% of the time.
Primary aldosteronism is a cause of secondary hypertension in 8%-20% of patients.
Obstructive sleep apnea is a cause of secondary hypertension 25% to 50% of the time.
Secondary hypertension is drug- or alchohol-induced in 2% to 4% of patients.
Uncommon causes of secondary hypertension include pheochromocytoma/paraganglioma, hypo- and hyperthyroidism, and Cushing syndrome.
