Secondary hypertension

Like essential hypertension, secondary hypertension often has no symptoms, especially in the early stages. The condition is often picked up during a routine health check and many people may be unaware that they have it.

If you do experience symptoms of hypertension, they may include:

• Chest pain that may radiate to your neck, jaw, back, stomach or arms
• Headaches
• Shortness of breath
• Nausea
• Vomiting
• Blurred or double vision
• Nosebleeds
• Dizziness or light-headedness
• Anxiety
• Confusion

Several health conditions can cause secondary hypertension including problems with your kidneys, hormonal imbalances and congenital health conditions (a condition you are born with). Secondary hypertension can also occur due to obesity, pregnancy and in response to certain drugs.

Some of the most common secondary hypertension causes include:

Adrenal gland problems

The adrenal glands are located on top of your kidneys and produce hormones that regulate your blood pressure. Problems with your adrenal glands such as Cushing syndrome, primary hyperaldosteronism (Conn’s syndrome), or a tumour can lead to hormone imbalances that increase blood pressure.

Thyroid disorders

High blood pressure can occur when your body makes excessive thyroid hormones (hyperthyroidism) or doesn’t produce enough thyroid hormones (hypothyroidism).

Hyperparathyroidism

The parathyroid glands are located in the neck and produce hormones that regulate calcium levels in the blood. If these glands produce too much parathyroid hormone, it can cause high blood pressure.

Kidney diseases

Several kidney diseases including diabetic nephropathy, renal artery stenosis, glomerular disease, renovascular hypertension, and polycystic kidney disease interfere with kidney function and can lead to secondary hypertension.

Fibromuscular dysplasia

This is a rare condition that causes some of your arteries to narrow and grow larger. Narrowed arteries that supply your kidneys can reduce blood flow and lead to secondary hypertension.

Sleep apnoea

Sleep apnoea is a condition where you stop breathing for short periods during sleep. Secondary hypertension may occur due to lack of oxygen leading to damage of the blood vessel walls and the release of certain blood pressure-raising chemicals caused by changes to your nervous system.

Obesity

Being overweight or obese can increase the amount of blood flowing through your body, making the heart work harder, and increasing blood pressure. 

Coarctation of the aorta

This is a congenital condition where your aorta (main artery) is narrowed,  making your heart work harder and increasing your blood pressure.

Pregnancy

High blood pressure during pregnancy can develop for unknown reasons (gestational hypertension) or may occur due to conditions such as preeclampsia. If you have already been diagnosed with high blood pressure, it may get worse during pregnancy. 

Drug-induced hypertension

This is a type of secondary hypertension caused by the use of medication, supplements or illegal drugs. High blood pressure can be a side effect of several prescription medications including the contraceptive pill, non-steroidal anti-inflammatory drugs (NSAIDs), decongestants, and antidepressants. It can also be caused by some herbal supplements, such as ginseng, liquorice, St. John’s wort and ephedra. Drug-induced hypertension can also be caused by alcohol and some recreational drugs such as cocaine, ecstasy and methamphetamine. 

The cost of treatment for and management of secondary hypertension will differ significantly from person to person, as it is affected by multiple factors – from the underlying causes to the medications needed, as well as any scans, tests or procedures you need during your treatment.

Treatment prices also vary from hospital to hospital and depending on which consultant you choose.

To get an idea of secondary hypertension treatment prices, you can give our advisors a call or speak to them directly via live chat.

If you have private medical insurance, this type of treatment may be covered by your policy. Speak directly to your insurer to find out. We accept private health insurance as well as offering a self-pay option.

At your first consultation, you will typically be seen by a consultant cardiologist, a doctor specialising in conditions affecting the heart. Your first appointment is important as it’s where you’ll meet your consultant, the doctor responsible for your care. At your appointment, your consultant will ask you about your symptoms, family and medical history and general health. They will perform a physical examination including checking your blood pressure. You may need to have your blood pressure checked on several occasions for your consultant to get an accurate picture of your overall blood pressure.

During your appointment, your consultant will spend time getting to know you, discuss your expectations for treatment and encourage you to ask any questions you may have. At Circle Health Group, we want you to be as well-informed and comfortable as possible during your time with us, so please discuss any questions or concerns with your consultant during your appointment. 

Your consultant will diagnose secondary hypertension using a combination of your symptoms, medical history, physical examination and the results of any tests and scans. Your consultant may suspect secondary hypertension if:

• You are diagnosed with sudden-onset high blood pressure under the age of 30 or over the age of 55
• You have no family history of hypertension 
• You have resistant hypertension (high blood pressure that doesn't respond to standard blood pressure medications)
• Your blood pressure is very high (a systolic blood pressure over 180 mm Hg or a diastolic blood pressure over 120 mm Hg)
• Your hypertension no longer responds to medication that was once effective 
• You are not obese

If secondary hypertension is suspected, your consultant may order tests and/or scans to confirm the diagnosis and identify the underlying cause. These may include:

Blood tests

Can check for hyperaldosteronism by measuring the levels of the blood pressure hormones, aldosterone and renin in your blood. A blood test can also measure your potassium, sodium, glucose and cholesterol levels and check your kidney function.

24-hour urine test

Can identify the cause of your secondary hypertension by measuring the amount of salt and cortisol excreted in your urine over 24 hours.

Thyroid function tests

To check how well your thyroid gland is working and look for possible causes of your secondary hypertension such as hyperthyroidism or hypothyroidism.

Ambulatory blood pressure monitoring

This involves wearing a portable blood pressure monitor for 24 hours that takes regular readings and sends them to your consultant.

Imaging tests

Scans such as an ultrasound, MRI or CT scan can examine your kidneys for any narrowing of the kidney arteries or other abnormalities with the kidneys, adrenal glands or thoracic aorta.

Electrocardiogram (ECG)

Checks the electrical activity of your heart and looks for abnormalities that could be causing your secondary hypertension.

Treatment for secondary hypertension depends on what is causing the hypertension and involves treating the underlying condition. Your consultant may also recommend lifestyle changes and prescribe medication to help manage your hypertension. In some cases, your consultant may recommend surgery to treat the cause of your secondary hypertension.

Lifestyle changes

Making changes to your lifestyle can help keep your blood pressure within healthy limits and may help your blood pressure medication work more effectively. Some lifestyle changes that can improve your blood pressure or prevent it from getting worse include:

• Following a healthy, nutritious diet and limiting salt in your food. Our expert team of dieticians can work with you to create a healthy eating plan to help manage your hypertension. 
• Losing weight if needed and maintaining a healthy weight
• Increasing your activity by taking regular exercise, or engaging in activities like gardening, walking or household chores
• Keeping your alcohol intake within the recommended limits: The UK government recommends no more than 14 units of alcohol per week spread over three days 
• Stopping smoking

Medication

Your consultant may prescribe medication to treat the underlying cause of your secondary hypertension. In addition, you may be prescribed medication to lower your blood pressure such as ACE inhibitors, calcium channel blockers, diuretics, or beta-blockers. 

Surgery

Depending on the cause, surgery can sometimes be an option for treating secondary hypertension. Surgery can involve removing your adrenal gland, improving blood flow to your kidneys or destroying the nerve in the kidney artery wall.

Some types of surgery to treat secondary hypertension include:

• Laparoscopic adrenalectomy: A minimally invasive (keyhole) procedure to remove an overactive adrenal gland. 
• Renal artery stenting: Uses a catheter to insert a balloon and a mesh tube called a stent into your kidney artery to open the artery and improve blood flow. 
• Renal artery bypass: Involves grafting a blood vessel from another part of your body to improve blood flow to your kidneys.
• Renal artery denervation

Some types of secondary hypertension, such as tumours or blood vessel abnormalities can’t be prevented, but you can reduce your risk of developing other forms of secondary hypertension, especially if you have a condition that increases your chances of developing the disease.

Adopting a healthy lifestyle by following a low-salt diet, taking regular exercise, maintaining a healthy weight, limiting alcohol and avoiding smoking can reduce your risk of secondary hypertension.

If you think your secondary hypertension may be caused by your medication, discuss this with your consultant. Never stop taking a prescribed medication without first talking to your healthcare team.

Like all medical treatments, treatment for secondary hypertension can cause side effects in some people. Your consultant will discuss all the possible side effects or complications of your medication or surgery before starting treatment and answer any questions you may have. It is important that you are fully aware of any potential side effects or complications before your treatment starts as this will allow you to make an informed decision.

People with secondary hypertension normally respond well to treatment and can live full and active lives if the condition is well managed. You will need to have regular follow-up appointments to get your blood pressure checked, monitor your general health and any underlying medical conditions, and evaluate the effectiveness of any medication you are taking.

At Circle Health Group, we have the experience and expertise to ensure the best possible care and outcome for our patients. As a patient with Circle Health Group, you can expect the highest standards of care including:

• Flexible appointment times and locations that are convenient for you
• The freedom to choose which hospital and consultant suit your needs
• Personalised, consultant-led treatment plans tailored to your individual needs
• Comfortable and safe private facilities maintained by expert multidisciplinary teams
• Private ensuite rooms as standard
• A range of delicious healthy meals
• Affordable, fixed-price packages with aftercare included
• Flexible payment options to help you spread the cost of your care

If you would like to see a consultant or learn more about secondary hypertension treatment, book your appointment online today or call a member of our team directly.

Secondary causes of hypertension - National Institute for Health and Care Excellence (NICE) 
Secondary Hypertension - National Library of Medicine 
Biochemical investigation of secondary hypertension - Manchester University NHS Foundation Trust
Secondary Hypertension: Discovering the Underlying Cause - American Family Physician