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Causes

By Mayo Clinic staff

A number of conditions can cause secondary hypertension. These include:

  • Diabetes complications (diabetic nephropathy). Diabetes can damage your kidneys' filtering system, which can lead to high blood pressure.
  • Polycystic kidney disease. In this inherited condition, cysts in your kidneys prevent the kidneys from working normally and can raise blood pressure.
  • Glomerular disease. Your kidneys filter waste and sodium using microscopic-sized filters called glomeruli that can sometimes become swollen. If the swollen glomeruli can't work normally, you may develop high blood pressure.
  • Renovascular hypertension. This is a type of secondary hypertension caused by narrowing (stenosis) of one or both arteries leading to your kidneys. Renovascular hypertension can cause severe hypertension and irreversible kidney damage. It's often caused by the same type of fatty plaques that can damage your coronary arteries (atherosclerosis) or a separate condition in which the muscle and fibrous tissues of the renal artery wall thicken and harden into rings (fibromuscular dysplasia).
  • Cushing syndrome. In this condition, corticosteroid medications themselves may cause secondary hypertension, or hypertension may be caused by a pituitary tumor or other factors that cause the adrenal glands to produce too much of the hormone cortisol. This raises blood pressure.
  • Aldosteronism. In this condition, a tumor in the adrenal gland, increased growth of normal cells in the adrenal gland or other factors cause the adrenal glands to release an excessive amount of the hormone aldosterone. This makes your kidneys retain salt and water and lose too much potassium, which raises blood pressure.
  • Pheochromocytoma. This rare tumor, usually found in an adrenal gland, increases production of the hormones adrenaline and noradrenaline, which can lead to long-term high blood pressure or short-term spikes in blood pressure.
  • Thyroid problems. When the thyroid gland doesn't produce enough thyroid hormone (hypothyroidism) or produces too much thyroid hormone (hyperthyroidism), high blood pressure can result.
  • Hyperparathyroidism. The parathyroid glands regulate levels of calcium and phosphorus in your body. If the glands secrete too much parathyroid hormone, the amount of calcium in your blood rises — which triggers a rise in blood pressure.
  • Coarctation of the aorta. With this defect you're born with, the body's main artery (aorta) is narrowed (coarctation). This forces the heart to pump harder to get blood through the aorta and to the rest of your body. This, in turn, raises blood pressure — particularly in your arms.
  • Sleep apnea. In this condition, often marked by severe snoring, breathing repeatedly stops and starts during sleep, causing you to not get enough oxygen. Not getting enough oxygen may damage the lining of the blood vessel walls, which may make your blood vessels less effective in regulating your blood pressure. In addition, sleep apnea causes part of the nervous system to be overactive and release certain chemicals that increase blood pressure.
  • Obesity. As you gain weight, the amount of blood circulating through your body increases. This puts added pressure on your artery walls, increasing your blood pressure. Excess weight often is associated with an increase in heart rate and a reduction in the capacity of your blood vessels to transport blood. In addition, fat deposits can release chemicals that raise blood pressure. All of these factors can cause hypertension.
  • Pregnancy. Pregnancy can make existing high blood pressure worse, or may cause high blood pressure to develop (pregnancy-induced hypertension or preeclampsia).
  • Medications and supplements. Various prescription medications — such as pain relievers, antidepressants and drugs used after organ transplants — can cause or aggravate high blood pressure in some people. Birth control pills, decongestants and certain herbal supplements, including ginseng, licorice and ephedra (ma huang), may have the same effect. Many illegal drugs, such as cocaine and methamphetamine, also increase blood pressure.
Risk factors Symptoms
References
  1. McKean SC, et al. Principles and Practice of Hospital Medicine. New York, N.Y: The McGraw-Hill Companies; 2012. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=749. Accessed Jan. 25, 2013.
  2. Sukor N. Secondary hypertension: A condition not to be missed. Postgraduate Medical Journal. 2011;87:706.
  3. Kaplan NM, et al. Overview of hypertension in adults. http://www.uptodate.com/home. Accessed Jan. 25, 2013.
  4. Fuster V, ed. et al. Hurst's The Heart. 13th ed. New York, N.Y.: The McGraw-Hill Companies; 2011. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=5. Accessed Jan. 25, 2013.
  5. Lerma EV, et al. Current Diagnosis & Treatment: Nephrology & Hypertension. New York, N.Y.: The McGraw-Hill Companies; 2009. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=628. Accessed Jan. 25, 2013.
  6. Viera AJ, et al. Diagnosis of secondary hypertension: An age-based approach. American Family Physician. 2010;82:1471.
  7. Grossman E, et al. Drug-induced hypertension: An unappreciated cause of secondary hypertension. The American Journal of Medicine. 2012;125:14.
  8. Sheps SG (expert opinion). Mayo Clinic, Rochester, Minn. Jan. 20, 2013.
  9. The seventh report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure. Bethesda, Md.: National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/guidelines/hypertension/jnc7full.htm. Accessed Jan. 20, 2013.
  10. Your guide to lowering your blood pressure with DASH. National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/public/heart/hbp/dash/new_dash.pdf. Accessed Jan. 20, 2013.
  11. Riccioni G. Aliskiren in the treatment of hypertension and organ damage. Cardiovascular Therapeutics. 2011;29:77.
  12. FDA drug safety communication: New warning and contraindication for blood pressure medicines containing aliskiren (Tekturna). U.S. Food and Drug Administration. http://www.fda.gov/Drugs/DrugSafety/ucm300889.htm. Accessed Jan. 22, 2013.
  13. Aliskiren. Micromedex Healthcare Series. http://www.micromedex.com. Accessed Jan. 22, 2013.
  14. Grapefruit. Natural Medicines Comprehensive Database. http://www.naturaldatabase.com. Accessed Jan. 22, 2013.
DS01114 March 15, 2013

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