Secondary HTN Flashcards
What is the most common cause of secondary HTN?
Primary renal disease
- PSK
- Glomerular disease
- Fibromuscular dysplasia
Often presents with no symptoms
What is fibromuscular dysplasia?
- Areas of stenosis alternating with small aneurysms
- Causes reduced renal perfusion
- Kidneys hold onto more fluid
How would primary renal disease be detected?
- Elevated serum creatinine
- Abnormal urinalysis
What is Cushing’s syndrome?
- High circulating glucocorticoids
- Facilitate Na+ and water retention, which increases plasma volume and BP
What is primary aldosteronism?
- Adrenal gland releases too much aldosterone
- Tells kidneys to retain Na+ and water
How is primary aldosteronism detected?
- Unexplained hypokalaemia with urinary potassium wasting
Sometimes patients are normokalaemic - Low Renin
- High aldosterone
What is secondary aldosteronism?
- A cause outside the adrenal gland causes the adrenal gland to release too much aldosterone
- Tells kidneys to retain Na+ and water
How is secondary aldosteronism detected?
- High aldosterone
- High renin
What is Pheochromocytoma ?
Tumour in the adrenal gland
How can sleep apnoea cause an increase in BP?
Breathing stops and starts causing a decrease in oxygen, heart pumps harder to increase BP
How do brain tumours and encephalitis cause an increase in BP?
- Increased ICP decreases blood flow to parts of the brain
- The body tries to increase BP to force more blood up into the skull and brain
What is coarctation of the aorta?
- Congenital defect where part of the aorta is narrower than usual – rare
- Presents in young adults
How is coarctation of the aorta detected?
- Radio-femoral delay
- Low or unobtainable BP in legs
What thyroid conditions can cause a rise in BP?
- Hypothyroidism
- Primary hyperparathyroidism
What medications can cause a rise in BP?
- OCP
- NSAIDs
- Stimulants
- Calcineurin inhibitors
- Antidepressants (MAOI)
