Download While most forms of hypertension in humans have no known

Tests for the secondary arterial hypertension
While most forms of hypertension in humans have no known underlying cause (essential
hypertension or primary hypertension), about 10% of the cases, there is a known cause, and thus the
hypertension is secondary hypertension
Or the high blood pressure is a result of another condition, such as kidney disease or tumours
(pheochromocytoma and paraganglioma)
Secondary hypertension is more common in preadolescent children, with most cases caused by
renal disease.
Types
Hypertension secondary to other renal disorders
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Chronic renal failure
Kidney disease / renal artery stenosis
the normal physiological response to low blood pressure in the renal arteries is to increase
cardiac output (CO) to maintain the pressure needed for glomerular filtration. Here, however,
increased CO cannot solve the structural problems causing renal artery hypotension, with the
result that CO remains chronically elevated.
Renal segmental hypoplasia
Also known as Ask-Upmark kidney- kidney with a partially developed or atrophic renal cortex
Hypertension secondary to endocrine disorders
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Pheochromocytoma
a neuroendocrine tumor of the medulla of the adrenal glands (esp chromaffin cells), or extraadrenal chromaffin tissue that failed to involute after birth and secretes excessive amounts of
catecholamines, usually epinephrine and norepinephrine
Hyperaldosteronism (Conn's syndrome)
Cushing's disease
Hyperparathyroidism
Acromegaly
Hyperthyroidism
Hypothyroidism
Other secondary hypertension
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Obstructive sleep apnea
Liquorice (when consumed in excessive amounts)
Scleroderma
Neurofibromatosis
Pregnancy
Tests for the secondary arterial hypertension
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Cancers
tumours in the kidney can operate in the same way as kidney disease. More commonly,
however, tumors cause inessential hypertension by ectopic secretion of hormones involved in
normal physiological control of blood pressure.
Drugs
In particular, alcohol, nasal decongestants with adrenergic effects, NSAIDs, MAOIs,
adrenoceptor stimulants, and combined methods of hormonal contraception (those containing
ethinyl-estradiol) can cause hypertension while in use.
Malformed aorta, slow pulse - these cause reduced blood flow to the renal arteries
Aortic valve disease
Coarcation of the aorta
Anemia
Fever
Diagnosis
The ABCDE mnemonic can be used to help determine a secondary cause of hypertension
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A: Accuracy, Apnea, Aldosteronism
B: Bruits, Bad Kidney
C: Catecholamines, Coarctation of the Aorta, Cushing's Syndrome
D: Drugs, Diet
E: Erythropoietin, Endocrine Disorders
Laboratory Tests
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Urinalysis
Eg; Creatinine (renal function) – for chronic renal disease
to identify both underlying renal disease as a cause of hypertension and conversely
hypertension causing onset of kidney damage.
Complete blood count
Blood chemistries (potassium, sodium, creatinine, fasting glucose)
Fasting lipid profile (LDL, HDL, triglycerides, total cholesterol)
ABPM (ambulatory blood pressure monitoring) (in the routine evaluation and management of
children with hypertension)
http://en.wikipedia.org/wiki/Secondary_hypertension
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Testing of urine samples for proteinuria
For other underlying kidney disease or evidence of hypertensive renal damage.
 Electrocardiogram (EKG/ECG)
for evidence of the heart being under pressure from working against a high blood pressure. Also
may show resulting thickening of the heart muscle (left ventricular hypertrophy) or of the
occurrence of previous silent cardiac disease (either subtle electrical conduction disruption or
even a myocardial infarction).
 Chest X-ray - again for signs of cardiac enlargement or evidence of cardiac failure.
http://www.acupuncture.com.au/education/conditions/hypertension.html
http://www.themetaboliccenter.com/hypertension-diagnosis.php
Tests for the secondary arterial hypertension
Source : Wikipedia & answers.com
Ismail bin Sahari , 3051
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