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Causes
By Mayo Clinic staffA 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 condition in which the muscle and fibrous tissues of the renal artery wall thicken and harden into rings (fibromuscular dysplasia).
- Cushing's syndrome. In this condition, corticosteroid medications, a pituitary tumor or other factors 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, meaning you don't 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. In addition, excess weight often is associated with an increase in heart rate and a reduction in the capacity of your blood vessels to transport blood. All of these factors can increase blood pressure.
- 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 — from pain relievers to 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 and St. John's wort, may have the same effect. Many illegal drugs, such as cocaine and methamphetamine, also increase blood pressure.
References
- Onusko E. Diagnosing secondary hypertension. American Family Physician. 2003;68;67.
- Sutters M. Systemic hypertension. In: McPhee SJ, et al. Current Medical Diagnosis and Treatment. 49th ed. New York, N.Y.; McGraw-Hill Medical: 2010. http://www.accessmedicine.com/content.aspx?aID=3177080. Accessed July 9, 2010.
- Chobanian AV, et al. Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/guidelines/hypertension/jnc7full.pdf. Accessed July 9, 2010.
- Domino FJ, et al. Overview of hypertension in adults. http://www.uptodate.com/home/index.html. Accessed June 23, 2010.
- Chiong JR, et al. Secondary hypertension: Current diagnosis and treatment. International Journal of Cardiology. 2008;124;6.
- Kiani J, et al. Medicinal importance of grapefruit juice and its interaction with various drugs. Nutrition Journal. 2007;6;33.
- 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 July 9, 2010.
- Sheps S (expert opinion). Mayo Clinic, Rochester, Minn. July 12, 2010.
- Dietary Guidelines for Americans, 2010. U.S. Department of Health and Human Services. http://www.cnpp.usda.gov/DGAs2010-PolicyDocument.htm. Accessed Feb. 18, 2011.
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