Secondary hypertension

Secondary hypertension Hypertension secondary to an identifiable cause , seen in about 5 % to 10 % cases

When to suspect -severe or resistant hypertension onset at a young age ie < 30 yrs with○ no risk factors as family history or obesity○ ↑ common in younger people- close to 30 % in those 18-40 yrs malignant or accelerated hypertension acute rise in BP in a patient with previous normal readings absence of family h/o hypertension presence of target organ damage hypertension associated with electrolyte disorders onset of diastolic hypertension in patient older than 65 non dipping or reverse dipping during 24 hr ambulatory monitoring ( ie night time BP does not dip ( normal 10 % ) relative to day time BP.

more than expected drop in potassium with a small dose of diuretic more than expected decrease in GFR with a small dose of an ACE inhibitor ( ? renal artery stenosis ) BP drops with treatment but remains quite labile.

A wide variety of condition may cause 2ary hypertension - the following clues may help in narrowing down the possibilities /approach to further management.

Agewise -Children < 12 -renal parenchymal disease and coarctation of aorta

Adolescents 12-18...