Hypertension Causes

Aka: Hypertension Causes, Secondary Hypertension Causes, Hypertension Causes in Children, Hypertension Causes in Adolescents

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II. Causes: Common Secondary Hypertension by age

  1. Age under 18 years
    1. See below
    2. Secondary cause in 10-15% of cases (70-85% of cases if under age 11 years old)
    3. Aortic Coarctation (esp. males)
    4. Renal parenchymal disease (most common in under age <12 years)
      1. Glomerulonephritis
      2. Vesicoureteral Reflux Nephropathy
      3. Conngenital abnormalities
  2. Age 19 to 39 years
    1. Secondary cause in 5% of cases
    2. Renal Artery Stenosis due to fibromuscular dysplasia
    3. Thyroid Disease
    4. Renal parenchymal disease
  3. Age 40 to 64 years
    1. Secondary cause in 8 to 12% of cases
    2. Hyperaldosteronism
    3. Thyroid Disease
    4. Obstructive Sleep Apnea
    5. Cushing Syndrome
    6. Pheochromocytoma
  4. Age over 65 years
    1. Secondary cause in 17% of cases
    2. Renal Artery Stenosis due to atherosclerotic disease
    3. Chronic Kidney Disease
    4. Thyroid Disease (Hypothyroidism, Hyperthyroidism)
  5. References
    1. Viera (2010) Am Fam Physician 82(12): 1471-8 [PubMed]

III. Causes: Secondary Hypertension in Adults

  1. See Resistant Hypertension
  2. See Severe Hypertension
  3. Endocrine Causes
    1. Primary Aldosteronism
      1. Most common treatable secondary cause of Hypertension
      2. Evaluate as cause in Refractory Hypertension where Hypokalemia (even borderline low Potassium)
    2. Pheochromocytoma (rare)
    3. Cushing's Disease
    4. Hyperparathyroidism
      1. Consider in Hypertension with Hypercalcemia
    5. Thyroid Disease
      1. Hyperthyroidism causes systolic Hypertension
      2. Hypothyroidism causes diastolic Hypertension
        1. Dernellis (2002) Am Heart J 143:718-24 [PubMed]
  4. Vascular Causes
    1. Aortic Coarctation
    2. Renal Artery Stenosis
  5. Medications or substances
    1. See Medication Causes of Hypertension
    2. Antihypertensive Withdrawal
    3. Alcohol Withdrawal
    4. Cocaine or other stimulant
    5. Serotonin Syndrome
    6. Anticholinergic Syndrome
    7. Malignant Hyperthermia
  6. Miscellaneous causes
    1. Obstructive Sleep Apnea
    2. Renal parenchymal disease
    3. Preeclampsia (Pregnancy Induced Hypertension)
    4. Cerebrovascular Accident

IV. Causes: Secondary Hypertension in age <18 years old

  1. See Hypertension in Infants
  2. Renal parenchymal disease (Most common cause in children under age 12 years - up to 70%)
    1. Glomerulonephritis
    2. Vesicoureteral Reflux Nephropathy
  3. Vascular Causes
    1. Renal Artery Stenosis (due to fibromuscular dysplasia)
    2. Aortic Coarctation
  4. Endocrine conditions
    1. Metabolic Syndrome
    2. Pheochromocytoma
    3. Hyperthyroidism
    4. Cushing Syndrome
    5. Congenital Adrenal Hyperplasia
  5. Essential Hypertension
    1. Less common in age <10 years (although accounts for growing percentage in this age group)
    2. Most common cause in adolescents and adults
  6. Miscellaneous Causes
    1. Obstructive Sleep Apnea
    2. Rheumatologic Disorder
  7. Medications
    1. See Medication Causes of Hypertension
    2. See Medication causes listed above under adult section

V. References

  1. Charles (2017) Am Fam Physician 96(7): 453-61 [PubMed]

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Related Studies

Ontology: Hypertensive disease (C0020538)

Definition (MEDLINEPLUS)

Blood pressure is the force of your blood pushing against the walls of your arteries. Each time your heart beats, it pumps out blood into the arteries. Your blood pressure is highest when your heart beats, pumping the blood. This is called systolic pressure. When your heart is at rest, between beats, your blood pressure falls. This is the diastolic pressure.

Your blood pressure reading uses these two numbers, the systolic and diastolic pressures. Usually they are written one above or before the other. A reading of

  • 119/79 or lower is normal blood pressure
  • 140/90 or higher is high blood pressure
  • Between 120 and 139 for the top number, or between 80 and 89 for the bottom number is prehypertension

High blood pressure usually has no symptoms, but it can cause serious problems such as stroke, heart failure, heart attack and kidney failure. You can control high blood pressure through healthy lifestyle habits and taking medicines, if needed.

NIH: National Heart, Lung, and Blood Institute
Definition (NCI_CDISC) Pathological increase in blood pressure defined as one of the following: History of hypertension diagnosed and treated with medication, diet, and/or exercise; On at least 2 separate occasions, documented blood pressure greater than 140 mm Hg systolic and/or 90 mm Hg diastolic in patients without diabetes or chronic kidney disease, or blood pressure greater than 130 mm Hg systolic or 80 mm Hg diastolic in patients with diabetes or chronic kidney disease; Currently on pharmacological therapy for the treatment of hypertension.
Definition (NCI) Blood pressure that is abnormally high.
Definition (NCI_CTCAE) A disorder characterized by a pathological increase in blood pressure; a repeatedly elevation in the blood pressure exceeding 140 over 90 mm Hg.
Definition (NCI_NCI-GLOSS) A blood pressure of 140/90 or higher. High blood pressure usually has no symptoms. It can harm the arteries and cause an increase in the risk of stroke, heart attack, kidney failure, and blindness.
Definition (CSP) persistantly high arterial blood pressure.
Definition (MSH) Persistently high systemic arterial BLOOD PRESSURE. Based on multiple readings (BLOOD PRESSURE DETERMINATION), hypertension is currently defined as when SYSTOLIC PRESSURE is consistently greater than 140 mm Hg or when DIASTOLIC PRESSURE is consistently 90 mm Hg or more.
Concepts Disease or Syndrome (T047)
MSH D006973
ICD9 997.91, 401-405.99
ICD10 I10-I15.9 , I10, I10-I15
SnomedCT 38341003, 155302005, 194757006, 194760004, 155295004, 194756002, 266287006, 194794002, 195537001
LNC MTHU020789, LA14293-7, LA7444-8
English Hypertension, BLOOD PRESSURE HIGH, HYPERTENSION ARTERIAL, Hypertensive disease NOS, Hypertensive diseases, [X]Hypertensive diseases, Systemic hypertension, Hypertensive disorder, systemic arterial, hyperpiesia, hyperpiesis, systemic HTN, systemic hypertension (diagnosis), systemic hypertension, Hypertension arterial, Blood pressure high, HBP, HT, Hypertension NOS, Surg comp - hypertension, HTN, Hypertension [Disease/Finding], high blood pressure, hypertensive disorder, hypertensive vascular disease, arterial hypertension, arterial hypertension systemic, vascular hypertension, blood high pressure, high blood pressure disorder, systemic arterial hypertension, hypertensive disease, Hypertensive diseases (I10-I15), Complications affecting other specified body systems, not elsewhere classified, hypertension, High Blood Pressure, Hypertensive disease NOS (disorder), Hypertensive disease (disorder), (Hypertensive disease) or (hypertension), (Hypertensive disease) or (hypertension) (disorder), [X]Hypertensive diseases (disorder), hypertension, BLOOD PRESSURE, INCREASED, BLOOD PRESSURE, HIGH, Hypertensive Disorder, HIGH BLOOD PRESSURE, INCREASED BLOOD PRESSURE, HYPERTENSION, PRESSURE, HIGH BLOOD, High blood pressure, Hyperpiesia, Hyperpiesis, Hypertensive vascular degeneration, Hypertensive vascular disease, BP - High blood pressure, High blood pressure disorder, Systemic arterial hypertension, HBP - High blood pressure, BP+ - Hypertension, HT - Hypertension, Hypertensive disorder, systemic arterial (disorder), Hypertensive disorder, HTN - Hypertension, blood pressure; high, high; arterial tension, high; blood pressure, Hypertension, NOS, Hypertensive disease, NOS, Raised blood pressure (disorder), Blood Pressure, High, Blood Pressures, High, High Blood Pressures, Vascular Hypertensive Disorder, Hypertensive disease, HYPERTENSIVE DISEASE
French HYPERTENSION ARTERIELLE, Pression artérielle élevée, PAH, Hypertension SAI, TH, HYPERTENSION, TENSION ARTERIELLE E, Hypertension chronique, Hypertension permanente, Hypertension artérielle, Hypertension
Portuguese HIPERTENSAO, Hipertensão arterial NE, Hipertensão arterial, Pressão arterial alta, HYPERTENSAO ARTERIAL, PRESSAO SANGUINEA ELEVADA, Pressão Arterial Alta, Pressão Sanguínea Alta, Hipertensão
Spanish HIPERTENSION, PRESION SANGUINEA ALTA, Presión sanguínea alta, HTA, Hipertensión NEOM, Hipertensión arterial, HT, HIPERTENSION ARTERIAL, enfermedad hipertensiva, SAI, [X]enfermedades hipertensivas (trastorno), enfermedad hipertensiva, SAI (trastorno), [X]enfermedades hipertensivas, Hypertensive disease NOS, degeneración vascular hipertensiva, enfermedad hipertensiva, enfermedad vascular hipertensiva, hiperpiesia, hiperpiesis, hipertensión arterial (trastorno), hipertensión arterial, presión arterial alta, tensión arterial alta, tensión arterial elevada, Hipertensión, Presión Sanguínea Alta
German HYPERTONIE, Hypertonie, arteriell, Blutdruck, hoch, HBP, HT, Hypertonie NNB, BLUTDRUCK HOCH, HYPERTONIE ARTERIELL, Hypertension, Hypertonie
Dutch hypertensie NAO, hoge bloeddruk, arteriële hypertensie, bloeddruk; hoog, hoog; arteriële druk, hoog; bloeddruk, hypertensie, Bloeddruk, hoge, Hypertensie
Italian Ipertensione (HT), Ipertensione NAS, Pressione del sangue elevata, Ipertensione, Pressione sanguigna alta, Ipertensione arteriosa
Japanese 動脈性高血圧, 高血圧ＮＯＳ, ｺｳｹﾂｱﾂ, ｺｳｹﾂｱﾂNOS, ﾄﾞｳﾐｬｸｾｲｺｳｹﾂｱﾂ, 高血圧, 高血圧症
Swedish Högt blodtryck
Czech hypertenze, Arteriální hypertenze, Vysoký krevní tlak, Hypertenze NOS, Hypertenze, vysoký krevní tlak, hypertonie
Finnish Kohonnut verenpaine
Russian GIPERTENZIIA, GIPERTONICHESKAIA BOLEZN', KROVIANOE DAVLENIE VYSOKOE, ГИПЕРТЕНЗИЯ, ГИПЕРТОНИЧЕСКАЯ БОЛЕЗНЬ, КРОВЯНОЕ ДАВЛЕНИЕ ВЫСОКОЕ
Croatian HIPERTENZIJA
Polish Nadciśnienie
Hungarian Arteriás hypertonia, Hypertensio, HT, RR magas, Hypertonia k.m.n., Magas vérnyomás
Norwegian Høyt blodtrykk, Hypertensjon, Hypertoni
Derived from the NIH UMLS (Unified Medical Language System)

Ontology: Secondary hypertension (C0155616)

Concepts Disease or Syndrome (T047)
ICD9 405, 405.9
ICD10 I15 , I15.9
SnomedCT 155300002, 194789002, 194792003, 31992008
English Unspecified secondary hypertension, Secondary hypertension NOS, Secondary hypertension, unspecified, unspecified secondary hypertension (diagnosis), secondary hypertension (diagnosis), secondary hypertension, unspecified secondary hypertension, Hypertension secondary, hypertension secondary, Secondary hypertension NOS (disorder), Secondary hypertension, Secondary hypertension (disorder), hypertension; secondary, secondary; hypertension, Secondary hypertension, NOS, Secondary Hypertension, Hypertension;secondary
Italian Ipertensione secondaria, Ipertensione secondaria NAS, Ipertensione secondaria non specificata
Dutch hypertensie secundair, niet-gespecificeerde secundaire hypertensie, secundaire hypertensie, niet-gespecificeerd, secundaire hypertensie NAO, hypertensie; secundair, secundair; hypertensie, Secundaire hypertensie, niet gespecificeerd, secundaire hypertensie, Secundaire hypertensie
French Hypertension secondaire, non précisée, Hypertension secondaire SAI, Hypertension secondaire non précisée, Hypertension secondaire
German sekundaere Hypertonie, unspezifisch, sekundaere Hypertonie NNB, Hypertonie sekundaer, unspezifische sekundaere Hypertonie, Sekundaere Hypertonie, nicht naeher bezeichnet, Sekundaere Hypertonie, sekundaere Hypertonie
Portuguese Hipertensão secundária NE, Hipertensão arterial secundária NE, Hipertensão secundária
Spanish Hipertensión secundaria no especificada, Hipertensión secundaria NEOM, Secondary hypertension NOS, hipertensión secundaria, SAI, hipertensión secundaria, SAI (trastorno), hipertensión arterial secundaria (trastorno), hipertensión arterial secundaria, Hipertensión secundaria
Japanese 二次性高血圧、詳細不明, 二次性高血圧, 二次性高血圧ＮＯＳ, ﾆｼﾞｾｲｺｳｹﾂｱﾂｼｮｳｻｲﾌﾒｲ, ﾆｼﾞｾｲｺｳｹﾂｱﾂ, ﾆｼﾞｾｲｺｳｹﾂｱﾂNOS
Czech Blíže neurčená sekundární hypertenze, Hypertenze sekundární, Sekundární hypertenze, blíže neurčená, Sekundární hypertenze, Sekundární hypertenze NOS
Korean 이차 고혈압, 상세불명의 이차 고혈압
Hungarian Másodlagos hypertonia, Secundaer hypertonia, Másodlagos hypertonia k.m.n., Másodlagos hypertonia, nem meghatározott, Meghatározatlan másodlagos hypertonia
Derived from the NIH UMLS (Unified Medical Language System)

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