What is it?

Secondary high blood pressure (secondary hypertension) is high blood pressure that's caused by another medical condition. Secondary hypertension can be caused by conditions that affect the kidneys, arteries, heart or endocrine system. It can also occur during pregnancy. Secondary hypertension differs from the usual type of high blood pressure (primary hypertension or essential hypertension), which is often referred to simply as high blood pressure. Proper treatment of secondary hypertension can often control both the underlying condition and the high blood pressure, which reduces the risk of serious complications - including heart disease, kidney failure and stroke.

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Secondary Hypertension.

Additional names

This group contains additional names:
- Malignant Renovascular Hypertension
- Malignant renovascular HTN

Signs & symptoms

Like primary hypertension, secondary hypertension usually has no specific signs or symptoms, even if blood pressure has reached dangerously high levels.
If high blood pressure has been diagnosed, having any of these signs may mean the condition is secondary hypertension:
High blood pressure that doesn't respond to blood pressure medications (resistant hypertension)
- Very high blood pressure - systolic blood pressure over 180 millimeters of mercury (mm Hg) or diastolic blood pressure over 120 mm Hg
- High blood pressure that no longer responds to medication that previously controlled the blood pressure
- Sudden-onset high blood pressure before age 30 or after age 55
- No family history of high blood pressure
- No obesity


Diagnosis of secondary hypertension includes a blood pressure test by using an inflatable cuff. Then, a few more tests that check other markers to pinpoint the cause of the high blood pressure will be performed. These could include:
- Blood tests: Blood tests are often done to check the levels of potassium, sodium, creatinine, blood glucose, and total cholesterol and triglycerides, among others.
- A urine test (urinalysis)
- Ultrasound of the kidneys: Many kidney conditions are linked to secondary hypertension.
- Electrocardiogram (ECG or EKG): This painless noninvasive test records the electrical signals in the heart.


Treatment for secondary hypertension involves treating the underlying medical condition with medications or surgery. Once the underlying condition is treated, the blood pressure might decrease or return to normal. It might be needed to continue to take blood pressure medication as well, and any underlying medical condition you have may affect the choice of medication.
- Possible drug choices include:
- Thiazide diuretics
- Beta blockers
- Angiotensin-converting enzyme (ACE) inhibitors
- Angiotensin II receptor blockers
- Calcium channel blockers
- Direct renin inhibitors

Healthy lifestyle changes are recommended to keep the heart healthy and the blood pressure low. These include:
- Eating healthy foods
- Decreasing the salt in the diet
- Maintaining a healthy weight
- Increasing physical activity
- Limiting alcohol
- Not smoking
- Managing stress

☝️ This is not a substitute for professional medical advice. Please consult with your physician before making any medical decision.

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