Primary and Secondary hypertension

There are two type of hypertension either primary or secondary.

Most of our educated patients who suffers from hypertension are interested to know how we deal and categorize hypertension as they wish to know how they can help with the treatment and how they can better control their blood pressure. below is outline of hypertension causes.

Primary or Essential hypertension

means there is no clear-cut cause for it, any way there are some mechanisms may play a role to change the blood pressure like genetic factors, rich salt diet intake, endothelial dysfunction, and sedentary lifestyle. The main mechanism is increased peripheral resistance in arterioles. When the artery wall receive high blood flow, it may leads to intima damage and prepare for atherosclerotic plague formation.

you may have heard about target organ damage! what dose it mean? These organs affect by high blood pressure for long time and can lead to complication in eyes, kidneys, and left ventricle which increase the risk of vascular morbidity and mortality. So target organ damage result in bad prognosis for hypertension, and we should control the blood pressure before it damages these vital organs.

Secondary hypertension

Means there are an underline cause for hypertension which should be identified and corrected if possible.

We think about secondary hypertension in cases of:

• Resistant hypertension (there is no response to medical treatment.).
• Very high blood pressure more than 180 mm hg for systolic and more than 120 mm hg for diastolic.
• Sudden onset of high blood pressure before 30 years or after 55 of age.
• Patient has no family history for hypertension
• The patient not obese.

Here we have to look and search for the causes which may be:

1. Renal disorders (chronic pyelonephritis – glomerular disease - polycystic kidney – renal artery stenosis – diabetic nephropathy).
2. Vascular disease (Coarctation of aorta)
3. endocrine diseases(severe hypokalemia due to primary hyperaldosteronism – Cushing syndrome – pheochromocytoma, thyroid disease – hyperparathyroidism).
4. Pregnancy induced hypertension (the patient was not hypertensive before pregnancy).
5. Drugs and supplements: such as Alcohol (excess intake of alcohol) – cocaine –antidepressant – contraceptive – decongestant – licorice and Ginseng.
6. Obstructive sleep apnea.
7. Complaints for patient suffering from high blood pressure

Do you have any more questions about hypertension ? please visit our cardiology clinic and you will get all the positive answers for your hypertension. best regards

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