Secondary hypertension develops as a result. Symptomatic (secondary) arterial hypertension

Symptoms of pathology of other organs are added to high blood pressure. So, for renal hypertension concerns about swelling, changes in the amount of urine excreted and its character, possible fever, lower back pain.

Diagnosis of renal forms, as the most common ones, includes:

Urine examination (quantity, circadian rhythm, character of sediment, presence of microbes);
Radioisotope renography;
X-ray contrast pyelography, cystography;
Renal angiography;
Ultrasonography;
CT, MRI for probable space-occupying formations;
Kidney biopsy.

Endocrine hypertension, in addition to the actual increase in pressure, is accompanied by sympathoadrenal crises, weakness in mice, weight gain, and changes in diuresis. With pheochromocytoma, patients complain of sweating, attacks of trembling and palpitations, general anxiety, and headache. If the tumor proceeds without crises, then fainting conditions are present in the clinic.

Damage to the adrenal glands in Conn's syndrome causes, against the background of hypertension, severe weakness, excessive amounts of urine, especially at night, and thirst. The addition of fever may indicate a malignant tumor of the adrenal gland.

Weight gain in parallel with the appearance of hypertension, decreased sexual function, thirst, itchy skin, characteristic stretch marks (striae), and carbohydrate metabolism disorders indicate a possible Itsenko-Cushing syndrome.

Diagnostic search for endocrine secondary hypertension implies:

Complete blood count (leukocytosis, erythrocytosis);
Study of carbohydrate metabolism indicators (hyperglycemia);
Determination of blood electrolytes (,);
Blood and urine tests for hormones and their metabolites in accordance with the suspected cause of hypertension;
CT, MRI of the adrenal glands, pituitary gland.

Hemodynamic secondary hypertension is associated with pathology of the heart and blood vessels. They are characterized by an increase in predominantly systolic pressure. An unstable course of the disease is often observed, when an increase in blood pressure is replaced by hypotension. Patients complain of headache, weakness, discomfort in the heart area.

To diagnose hemodynamic forms of hypertension, the entire range of angiographic studies, ultrasound of the heart and blood vessels, and ECG are used; a lipid spectrum is required if atherosclerosis is suspected. A large amount of information in such patients is provided by routine listening to the heart and blood vessels, which allows one to determine the characteristic murmurs over the affected arteries and heart valves.

If neurogenic symptomatic hypertension is suspected They conduct a thorough neurological examination, clarify information about past injuries, neuroinfections, and brain surgeries. Symptoms of hypertension in such patients are accompanied by signs of autonomic dysfunction, intracranial hypertension (headache, vomiting), and possible convulsions.

The examination includes CT, MRI of the brain, assessment of neurological status, electroencephalography, possibly ultrasound and angiography of the cerebral vasculature.

Treatment of symptomatic hypertension

Treatment of secondary hypertension involves an individual approach to each patient, After all, the nature of the prescribed medications and procedures depends on the primary pathology.

With coarctation of the aorta, valvular defects, and anomalies of the renal vessels, the question is raised about the need for surgical correction of the changes. Tumors of the adrenal glands, pituitary gland, and kidneys are also subject to surgical removal.

In case of infectious and inflammatory processes in the kidneys, polycystic disease, antibacterial, anti-inflammatory drugs, restoration of water-salt metabolism are needed, in severe cases - hemodialysis or peritoneal dialysis.

Intracranial hypertension requires the prescription of additional diuretics; in some cases, anticonvulsant therapy is necessary, and large processes (tumor, hemorrhage) are removed surgically.

It involves prescribing the same groups of drugs that are effective in the case of essential hypertension. Shown:

(enalapril, perindopril);

In each case, the optimal treatment is selected based on the manifestations, first of all, of the causative pathology, which determines the indications and contraindications for each drug. The choice is made by the joint efforts of cardiologists, endocrinologists, neurologists, and surgeons.

Secondary arterial hypertension is a pressing problem for doctors of many specialties, because not only its identification, but also the determination of the cause is a complex and often lengthy process that requires numerous procedures. In this regard, it is very important that the patient sees a specialist as early as possible and outlines in as much detail as possible all his symptoms, the nature of the development of the pathology, medical history, family cases of certain diseases. Correct diagnosis of secondary hypertension is the key to successful treatment and prevention of its dangerous complications.

Video: lecture on arterial hypertension and its types

Hypertension (arterial hypertension)- constantly elevated blood pressure, which leads to disruption of the structure and function of the artery and heart. The incidence increases with age. More often observed in men. Sometimes there is a family predisposition, more often in African Americans. Risk factors are stress, alcohol abuse, salty foods and excess weight.

About 1 in 5 adults have persistently high blood pressure. High blood pressure causes the walls of the arteries and heart to stretch, damaging them. If left untreated, the blood vessels of the kidneys and eyes are damaged. The higher the blood pressure, the greater the likelihood of developing such severe complications as, and. Blood pressure in healthy people varies according to activity; it increases during exercise and decreases during rest. Normal blood pressure levels vary from person to person and may increase with age and weight. Blood pressure has two indicators, expressed in millimeters of mercury (mmHg). In a healthy person at rest, blood pressure should not exceed 120/80 mmHg. Art. If a person constantly, even at rest, has a blood pressure of at least 140/90 mmHg. Art. , he is diagnosed "hypertension".

At the onset of the disease hypertension It is asymptomatic, but if the pressure is constantly elevated, the patient begins to experience headaches, dizziness and double vision. In most cases, only symptoms caused by increased blood pressure are of concern. Over time, they intensify and by the time the disease is obvious, irreversible changes in organs and arterial vessels have already formed. No wonder hypertension called the “silent killer”: people often die from or that were a complete surprise to them.

Recently, programs to promote a healthy lifestyle and universal medical examination have made it possible to diagnose hypertension in many people at an early stage. Early diagnosis and advances in treatment can greatly reduce the incidence of strokes and heart attacks in the population.

In approximately 9 out of 10 hypertensive patients, no obvious cause of the disease was found. But it is known that lifestyle and genetics make a significant contribution. Hypertension It often develops in middle age and in older people due to age-related changes in the arteries. High blood pressure is more common in men. Excess weight and alcohol abuse increase the likelihood of developing hypertension, and stress only aggravates the condition. That is why the incidence rate is so high in developed countries. This condition is rarely observed in countries where the diet is low in salt (which makes it a risk factor).

Predisposition to hypertension may be hereditary: in America, the disease is more common in African Americans. In rare cases the reason hypertension can be determined. Its cause may be kidney disease or hormonal disorders - such as or. Some medications - or - may cause hypertension.

In pregnant women, high blood pressure can cause preeclampsia and eclampsia, life-threatening conditions. High blood pressure usually returns to normal after the baby is born.

The likelihood of damage to the kidneys, arteries and heart increases depending on the severity, disease and its duration. Damaged arteries are less resistant to cholesterol; cholesterol plaques form faster on their walls, narrowing the lumen and limiting blood flow.

It develops more quickly in smokers and people with high cholesterol levels. leads to severe chest pain or. If other arteries are affected, an aortic aneurysm or stroke may occur. Hypertension increases the load on the heart, and, as a result, chronic heart failure develops. Damage to the renal arteries results in chronic renal failure. Hypertension also destroys the arteries of the retina.

You should have your blood pressure checked regularly every 2 years after age 18. If the blood pressure value is above 140/90 mm Hg. Art. , it is necessary to undergo a re-examination in a few weeks (some patients are nervous at the doctor's appointment, because of this the pressure rises.) Diagnosis "hypertension" placed if high blood pressure is detected three times in a row. If your blood pressure is constantly changing, you need to purchase a device for regular blood pressure measurements at home. After diagnosis, it is necessary to undergo studies to identify possible organ damage. For the heart, echo and electrocardiography are performed. It is also necessary to examine the blood vessels of the eyes, additional tests are needed - for example, determining the level of cholesterol in the blood, the increase of which increases the risk of developing myocardial infarction.

Young people or severely hypertensive patients need to undergo a full examination to identify the cause hypertension(urine and blood tests and ultrasound examinations to detect kidney disease or hormonal disorders).

Hypertension usually cannot be cured, but blood pressure can be controlled. If your blood pressure is slightly elevated, the best way to reduce it is to change your lifestyle. You should reduce your salt and alcohol intake and keep your weight normal. It is necessary to quit smoking if the patient smokes. If these measures do not lead to a decrease in pressure, it is necessary to use drug therapy -. These drugs work differently, so it is possible to prescribe one or more drugs. It takes time to choose the right type of medication and its dosage. If side effects develop, you should immediately inform your doctor so that he can make appropriate changes.

Some doctors recommend regularly measuring your blood pressure yourself, this allows you to evaluate the effectiveness of treatment. If developed hypertension - a consequence of another disease, for example, a hormonal disorder, then its treatment will bring the pressure back to normal.

The prognosis depends on how long and how high the patient’s blood pressure has been. In most cases, lifestyle changes and drug control of blood pressure can significantly reduce the risk of further complications. You should monitor your blood pressure throughout your life. The risk of complications is greatest with long-standing and severe hypertension.

Arterial hypertension or hypertension is characterized by a chronic increase in blood pressure. In turn, the disease is divided into two types: primary and secondary. If primary hypertension occurs due to disturbances in the functioning of blood vessels, then the second form is a consequence of any diseases of other body systems.

The primary type of hypertension is much more common among patients. Secondary requires not only treatment of the cardiovascular system, but also those organs whose malfunction provoked surges in blood pressure.

Secondary hypertension - what is it?

Often this form of hypertension is caused by a disruption of the endocrine system or kidneys. This type of disease is characterized by very high readings on the tonometer (over 180-200).

With standard treatment prescribed for all hypertensive patients, blood pressure decreases slightly. Such a reaction of the body to seemingly universal drugs becomes the first alarm bell. If you only treat the consequences, the root cause will not go away on its own.

Causes of arterial secondary hypertension

The causes of secondary hypertension can be disturbances in the functioning of the kidneys, adrenal glands, endocrine system, pituitary gland, cardiac pathologies, central or peripheral nervous system, pathologies of the heart valves or tumors.

What is the difference between primary and secondary hypertension?

If the primary form of hypertension is the most common, then the secondary form occurs in approximately every fourth or fifth hypertensive patient.

The primary form does not have any specific reason for its occurrence. Both types of diseases are characterized by the same symptoms: headaches, loss of appetite, tachycardia, swelling of certain parts of the body, nausea, memory impairment and black “dots” before the eyes.

The symptoms are mild and can easily be attributed to malaise or a consequence of overwork.

However, with secondary hypertension, the patient requires more complex treatment, because high blood pressure in these patients is caused by other, more serious diseases.

Classification

Secondary arterial hypertension is classified into five main forms:

hemodynamic;
endocrine;
medicinal;
nephrogenic;
neurogenic.

Hemodynamic hypertension can be caused by heart disease, pathologies of the valves and aorta.

Endocrine type The disease is caused by problems in the functioning of the endocrine system of the human body. The endocrine form, in turn, is divided into several types:

pituitary;
adrenal.

Medicinal Hypertension occurs as a consequence of taking certain types of medications to treat other diseases.

Nephrogenic form caused by disturbances in the functioning of the renal vessels.

Neurogenic form The disease occurs when the functioning of the central nervous system is disrupted.

Each form occurs when the functioning of the relevant organs is disrupted. However, some medical specialists use a different version of the classification of this disease.

By the nature of development:

renoprivative;
renoparenchymatous;
renovascular secondary forms.

In any case, the diagnosis and form of the disease should be established only by a specialist.

Diagnostics

In terms of symptoms, secondary hypertension is practically no different from primary hypertension. It is characterized by headaches, increased sweating, memory loss and facial flushing.

Having established hypertension, specialists often resort to differential diagnosis to determine its classification. So, for example, if a hypertensive patient is not obese, there are no problems with blood pressure in his family (i.e., there is no genetic predisposition), and he is relatively young (from 30 to 45 years old), specialists will already weed out primary hypertension and consider secondary hypertension as main diagnosis.

This will complete the first stage of diagnosis.

It will be followed by a second, which includes a study of the structure and functioning of internal organs in order to find the cause of chronic high blood pressure.

Arterial secondary hypertension - treatment

Treatment for this disease can be either medication or surgery.

Initially, after diagnosing the disease and carrying out all the necessary tests, its root cause is established. It is the cause of high blood pressure that will be treated initially. Well medications can only be prescribed by a doctor.

If hypertension is caused by vascular pathologies or tumors, specialists will have to resort to surgical intervention.

In parallel with the treatment of the underlying disease, the patient will be prescribed urs of standard drugs for hypertensive patients suffering from any form of disease:

ACE inhibitors;
calcium antagonists;
beta blockers;
diuretics.

However, the effectiveness of all of the above drugs will be much lower than in the treatment of primary hypertension.

This is one of the unpleasant symptoms of the disease: a weak reaction to medications that lower blood pressure. It should be remembered that with such a severe form of the disease, you should under no circumstances try to treat yourself. Even if the signs of the disease are removed, its source will continue to undermine the functioning of the patient’s body.

Prevention of this type of disease is divided into two types:

primary;
secondary.

For primary characterized by methods that strengthen the general condition of a person and work to prevent possible causes of hypertension.

Primary prevention includes therapeutic diets, in which a person should limit the consumption of sweet, fatty, spicy and salty foods; maintaining a daily routine and eight hours of sleep, avoiding stressful situations, completely quitting smoking and drinking alcohol; regular physical activity.

Secondary prevention arterial hypertension is to prevent the occurrence of complications in hypertensive patients. This type of prevention can be medicinal or non-medicinal.

In the first form of prevention, medical specialists prescribe a special course of drugs that provokes a decrease in blood pressure. Non-drug prevention is essentially no different from primary prevention.

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Arterial hypertension is divided into primary and secondary. In 90% of cases, hypertension occurs directly, which is accompanied by a systematic increase in blood pressure. The reason for blood pressure deviation from the norm is difficult to establish.

Factors influencing the development of the disease are identified. By correcting them, blood pressure is brought back to normal.

In 10% of cases, high blood pressure is a symptom of other diseases that affect blood circulation and heart function. Normalization of blood pressure in this case depends on successful treatment of the underlying disease.

Forms of the disease

Form of hypertension

Description and symptoms

Primary arterial hypertension

I degree – 140–159/90–99 mm Hg. Art. Intermittent blood pressure. It rises and quickly returns to normal without consequences. Occasionally, hypertensive crises occur; target organs are not affected.

II degree– 160–179/100–109 mm Hg. Art. Blood pressure surges are sometimes followed by periods of decline. Sharp and prolonged attacks occur more often, and target organs are affected.

III degree – 180/110 mm Hg. Art. and higher. Complications arise in the form of atherosclerosis and heart disease. Target organs (kidneys, brain, eyes, heart) are severely affected.

Secondary hypertension

Depending on the underlying disease, there may be renal, endocrine, hemodynamic and neurogenic hypertension. Drug or surgical treatment targets the affected organ rather than reducing pressure.

Renal hypertension

Develops as a sign of kidney damage, which is always accompanied by impaired blood supply. In case of kidney diseases (gromerulonephritis, pyelonephritis, stones, tumors, prolapse), sodium accumulates in the cells. It traps excess fluid in the walls of blood vessels, narrowing them. Spasm and hypertension occur.

Endocrine form

Detects disorders of the endocrine glands. Including thyrotoxicosis, pheochromocytoma, hyperthyroidism, primary hyperaldosteronism (Conn's syndrome). When the activity of the gonads decreases, pressure also increases. An increased flow of hormones into the blood provokes a narrowing of the arteries and causes the development of the disease.

Hemodynamic form

It can be seen in atherosclerosis and coarctation of the aorta. High blood pressure is caused by plaque or a difference between the blood supply to the lower and upper parts of the body.

Neurogenic form

It is observed when there is damage or inflammation of the spinal cord and brain. For example, tumors, injuries, bulbar poliomyelitis, encephalitis. The blood vessels are compressed and the pressure rises.

Causes of primary hypertension

Primary (essential) hypertension develops as a result of impaired arterial tone, which leads to increased blood pressure. Vascular tone is influenced by various external circumstances.

First of all, it’s chronic stress! It leads to hypertension, which manifests itself as anxiety, headaches, and panic attacks. The nervous system reacts to the stimulus with increased production of stress hormones, which enter the blood and have a vasoconstrictor effect.

Excitation is transmitted to the heart muscle, and the heart rate increases. With prolonged and frequent emotional stress, the body gets used to new conditions and accepts high blood pressure as the norm.

The condition is complicated by a genetic predisposition to the pathology. Doctors often say that hypertension is hereditary. Other risk factors include lack of physical activity, occupational characteristics, unhealthy diet, alcohol and salt abuse, smoking, weather dependence and age-related changes.

Accordingly, treatment of primary hypertension is based on combating mental disorders and lifestyle changes. Taking medications that lower blood pressure at the initial stage of development of the disease is not recommended. The exception is its frequent surges and hypertensive crisis.

Causes of secondary hypertension

Secondary (symptomatic) hypertension is caused by diseases of the organs involved in the circulatory process.

Kidney disease is inevitably accompanied by a rise in blood pressure. This is explained by the fact that the kidneys are the most blood-supplied organs. They participate in hematopoiesis and produce renin, which constricts blood vessels.

Diseases of the endocrine system lead to an increase in blood pressure due to disruption of the process of hormone production. Disorders of the endocrine glands (pituitary gland, thyroid gland, adrenal glands, gonads) provoke an increased release of hormones into the blood that sharply increase blood pressure. Hypertension, complicated, is formed.

Brain damage and tumors can cause secondary hypertension. This is facilitated by intracranial pressure and nervous system disorders.

Among cardiovascular diseases, congenital heart disease – coarctation of the aorta – stands out. The pressure in the arteries of the upper half of the body increases, and in the arteries of the lower half it decreases. The difference is detected when measuring it on the arms and legs or after an ECG.

Secondary arterial pathology can be caused by the use of drugs. Some cold drops, anti-inflammatory and contraceptive drugs stimulate the release of hormones and have a side effect of increasing blood pressure.

Treatment of secondary hypertension begins with the prescription of one drug. If the medicine does not normalize blood pressure well, the doctor may add a second drug to the treatment regimen. In the vast majority of cases, taking medications for hypertensive patients becomes a lifelong recommendation.

First aid for high blood pressure

Progression of the disease increases the likelihood of a hypertensive crisis. A sharp rise in pressure has dangerous consequences for the brain and heart and can threaten a person’s life. In some cases, medical assistance may need to be provided within a few minutes. It is better to call an ambulance than to wait for the symptoms to disappear.

Before the doctor arrives, you should:

Restore even breathing, take a comfortable lying or sitting position.
Warm your feet with a heating pad or your calf muscles with mustard plasters.
Take medicine pre-selected by your doctor in case of a crisis.
Don't eat, you can drink water.
Take nitroglycerin under the tongue if chest pain occurs.

Treatment of hypertension and prevention of high blood pressure

The chronic nature of arterial hypertension does not allow us to talk about curing the disease. The goal of therapy is to avoid complications and prolong the period without exacerbations. Successful treatment requires regular blood pressure measurements and following doctor's orders.

Treatment methods for mild and moderate forms:

Treatment without drugs. To reduce blood pressure, it is enough to create favorable conditions, without which even medications will be useless. It is better to reduce stress, eat right, and avoid smoking. It would be good to reduce your salt intake and exercise. These measures are mandatory at any stage of therapy and are observed for prevention. Additionally, it is recommended to take vitamins A, group B, C, P, K.
Monotherapy. It is practiced in the absence of significant results from a non-drug approach, but does not replace it. One suitable drug is selected individually, taking into account the characteristics of the diagnosis and concomitant diseases. Reception begins with a minimum dose and does not stop regardless of improvement of the condition. Only a doctor can cancel it.
Combination of drugs. In the absence of effect from monotherapy, the administration of low doses of several drugs is considered better than increased doses of one drug.
Phytotherapy. Gentle herbal infusions are used when taking pills is impossible. More often with an additional measure of pressure regulation without complications.

It is important to control your blood pressure throughout the day! Visit your doctor once a month and follow the recommendations for prevention. Do not forget that smoking and alcohol can cause a hypertensive crisis at the most inopportune moment. And the ambulance may simply not have time to save a person’s life.

THERE ARE CONTRAINDICATIONS
CONSULTATION WITH YOUR DOCTOR IS REQUIRED

Author of the article Ivanova Svetlana Anatolyevna, general practitioner

In contact with

If high blood pressure occurs against the background of diseases of the heart, blood vessels, kidneys, endocrine disorders, pathologies of nervous regulation, then such hypertension is called secondary. More than 50 diseases are known in which systemic pressure increases. Such conditions are characterized by a severe course and weak effect from traditional antihypertensive therapy, and the early development of complications. Treatment requires addressing the cause of hypertension.

Secondary hypertension accounts for about 10% of all detected increases in blood pressure. The most common causes of this pathology include:

diseases of the nervous system - concussion, neuropathy, tumor, meningoencephalitis, stroke;
kidney damage - structural anomalies, narrowing or compression of blood vessels, pyelo- or glomerulonephritis, nephrosclerosis, polycystic disease; high blood pressure provokes the deposition of amyloid in tissues, inflammation of blood vessels, including autoimmune origin, prolapse of the kidneys or their removal;
hormonal imbalance during menopause, pathology of the thyroid and parathyroid glands, pituitary gland or adrenal glands;
hemodynamic changes with, or insufficiency of the aortic valves, narrowing of the arteries supplying the brain;
taking medications - corticosteroids, birth control pills, Thyroxine, Indomethacin, antidepressants.

Classification

Secondary hypertension may be transient. In this case, the pressure increases slightly and sporadically. There are no changes in the fundus; there is no enlargement of the left ventricular myocardium. In the labile form, these manifestations are mild, and the pressure is moderately high, decreasing only after taking medications.

It is most convenient to distinguish clinical forms of arterial hypertension by etiological factor, since diagnosis and treatment are carried out in accordance with the cause of the disease.

Left ventricular hypertrophy is a cause of secondary hypertension

Arterial hemodynamic

Occurs when the lumen of the aorta narrows. One such obstruction to blood flow is coarctation. This is a congenital developmental anomaly in which there is a segmental narrow area.

The examination reveals the following deviations:

weak pulsation of the femoral arteries,
increased apical impulse,
systolic murmur at the base of the heart, apex and vessels of the neck.

Pulmonary hypertension

Increased pressure in the pulmonary vascular system can be a manifestation of an autoimmune process, heart disease, chronic bronchial diseases, and vascular thrombosis. Those at high risk are HIV-infected people who take drugs, centrally acting appetite suppressants, and contraceptives.

Manifestations of pulmonary hypertension in the early stages are increased fatigue, difficulty breathing, rapid heartbeat with little exertion, and then at rest. As hypoxia increases, fainting states, arrhythmia, cough with attacks of suffocation, the appearance of blood in the sputum, pain in the right hypochondrium and swelling of the legs are noted. Severe ones are accompanied.

Renal

With inflammatory processes in the kidney tissue, nephropathy due to gout or diabetes, polycystic hypertension is a late complication. Kidney pathology can be suspected if high blood pressure is detected at a young age and there are no cardiac or brain disorders.

A distinctive feature of such diseases is the rapid progression of renal failure, the appearance of swelling of the face and legs, and impaired urination.

Damage to the renal arteries (renovascular hypertension) begins suddenly, the patient’s condition deteriorates sharply, and drugs to lower blood pressure have virtually no effect. A quarter of patients have signs of a malignant course. The main reason - .

Pheochromocytoma

An adrenal tumor has the ability to produce cortical hormones - adrenaline, norepinephrine and dopamine. High blood pressure is accompanied by intense headaches, hand tremors, increased sweating, frequent and strong heartbeat, crises with panic attacks. Body temperature is elevated, can reach 38 - 39 degrees.

Primary aldosteronism

Occurs with adenoma of the adrenal cortex. There is sodium and fluid retention with simultaneous loss of potassium. Traditional medications do not lower blood pressure, muscle weakness, convulsions, severe thirst, and predominance of night urination are noted. Hypertensive crises can end in attacks of cardiac asthma, swelling of the lung tissue, a decrease in the contractility of the heart, and stroke.

Itsenko-Cushing syndrome

Caused by increased production of glucocorticoids by the adrenal glands. High blood pressure is at a consistently high level, there are no crises, and patients do not respond to antihypertensive drugs.

The diagnosis is helped by the typical appearance - moon-shaped face, obesity, hirsutism, purple stretch marks on the skin of the abdomen and thighs.

Medication

Drugs that provoke high blood pressure have a vasoconstrictor effect, retain fluid in the body, and increase blood density. The main such groups are:

adrenergic and sympathomimetics – Ephedrine, Pseudoephedrine (used in drops and tablets for the common cold);
non-steroidal anti-inflammatory drugs - inhibit the formation of prostaglandins, which dilate the lumen of the arteries;
analogues of female sex hormones, including contraceptives - stimulate the renin-angiotensin system, retain fluid in the body;
antidepressants, especially tricyclics, stimulate the activity of the sympathetic nervous system and constrict the arteries;
glucocorticoids retain sodium and increase sensitivity to vasoconstrictors.

Neurogenic

It happens during an inflammatory process, a brain tumor, traumatic brain injury, ischemic attacks. In addition to hypertension, there is a severe headache, periodic attacks of dizziness and fainting, convulsions, unsteadiness when walking, impaired coordination of movements, vision, and speech.

Watch the video about hypertension and its treatment:

Diagnosis of secondary symptomatic hypertension

A secondary increase in blood pressure can be suspected based on the following signs:

the patient is under 20 years old or over 65;
acute onset with high numbers;
the course is malignant;
Complications quickly increase (stroke, heart attack, pulmonary edema, retinal detachment);
development of crises with high activity of the sympathetic system;
the presence of diseases that provoke hypertension;
low response to .

Diagnostic methods differ for different types of secondary hypertension. The most informative ones are:

for coarctation of the aorta and pulmonary hypertension, chest x-ray, ultrasound and;
for kidney diseases - urine examination (protein, red blood cells, casts, leukocytes, low density), kidney ultrasound (inflammation, cysts, heterogeneity of parenchyma, dilated pelvis), increased nitrogen compounds in the blood; to determine filtration capacity, a renogram, urogram, angiography, MRI of the kidneys or CT, and biopsy are used;
if catecholamines are increased in the urine, ultrasound or MRI of the adrenal glands, radioisotope diagnostics can be used to determine the activity of hormone synthesis and metastasis;
with aldosteronism, there is increased aldosterone and blood sodium, low potassium, chloride ions, radioisotope scanning helps visualize the tumor, the degree of enlargement of the adrenal cortex;
for Itsenko-Cushing's disease - high blood 17-hydroxyketosteroids, hydrocortisone; if it is difficult to make a diagnosis, ultrasound, CT or MRI of the adrenal glands or their scanning after the administration of radioisotope drugs are prescribed;
neurogenic hypertension is diagnosed on the basis of CT and MRI of the brain, ultrasound of the vessels of the head, and angiography.

Treatment of the disease

Since in the vast majority of cases medications do not have a significant effect on the course of secondary arterial hypertension, surgical treatment is prescribed. Its choice is determined by the type of pathology and existing complications. It is most advisable to perform surgery before the development of persistent negative changes in the lungs, heart, brain and kidneys.

When coarctation of the aorta is performed, its surgical reconstruction is carried out by excision of the narrowed area and stitching or prosthetics, as well as the creation of bypass paths for blood flow. The operation is prescribed only in the early stages.

If the cause of high blood pressure is, then anticoagulants and oxygen inhalations are indicated; in case of heart defects, their prompt elimination is necessary.

Treatment of nephritis is carried out using anti-inflammatory drugs and diuretics. Vasorenal hypertension requires the following types of surgical interventions:

plastic surgery of arteries
stent installation,
renal artery reconstruction,
creating a connection (anastomosis) to bypass the narrowing.

Tumors of the adrenal gland, pituitary gland or brain must be removed. Neurogenic hypertension is treated with the use of drugs that reduce the manifestations of hypoxia and ischemia of brain tissue.

Prevention of disease development

Primary preventive measures for symptomatic hypertension come down to preventing malformations of the heart and blood vessels, eliminating stressful and toxic effects on the body, avoiding excessive sun exposure, giving up bad habits, normalizing nutrition and lifestyle. The use of medications is carried out only after prescription or agreement with a cardiologist.

In order to stop the progression of diseases, a timely visit to a doctor is required and a full range of examinations are required to detect the cause of high blood pressure. Taking medications, as well as surgical treatment in the early stages, allows you to avoid such severe, sometimes fatal complications of hypertension as cardiac asthma, pulmonary edema, heart attack, stroke, and renal failure.

Secondary hypertension occurs against the background of diseases of the blood vessels, kidneys, lungs, endocrine organs, and nervous system. This group of diseases is characterized by a severe course and low effectiveness of traditional antihypertensive therapy.

To identify the cause of symptomatic hypertension, diagnostic tests are required; CT, MRI and radioisotope scanning may be prescribed in complex cases. Treatment is carried out by influencing the underlying pathology, most often surgical interventions are indicated.