Causes Of Secondary Hypertension

Cardiovascular

  • Coarctation of the aorta
  • Mid-aortic syndrome
  • Aortic Tumours

Endocrine

  • Primary Aldosteronism*
  • Phaeochromocytoma
  • Cushing’s Syndrome, Acromegaly
  • Hyperthyroidism, hyperparathyroidism
  • Tumours: Ectopic ACTH, 11-Desoxycorticosterone-secreting

Monogenic

  • Liddle’s Syndrome
  • Apparent mineralocorticoid excess (AME)
  • Steroid deficiencies: 11β-hydroxylase, 17α-hydroxylase
  • Familial Hyperaldosteronism Type I (GRA) and II
  • Hypertension exacerbated by pregnancy (activating MR mutations)

Renal

  • Acute / Chronic Kidney Disease (AKD / CKD)
  • Renovascular hypertension (FMD, RAS)
  • Polycystic Kidney Disease
  • Diabetic Nephropathy
  • Gordon’s Syndrome
  • Renin-secreting tumours

Drugs(consider also withdrawal of anti-hypertensive drugs)

  • Over the counter (sympathomimetics), COX-2 Inhibitors, NSAIDs
  • Recreational (amphetamines, cocaine)
  • Liquorice, corticosteroids, anabolic steroids, OCP
  • Ciclosporin, Tacrolimus, Leflunomide
  • Ergot alkaloids, MAOIs, TCAs
  • Anaesthetics – ketamine
  • Herbal remedies
  • Alcohol

Neurologic hypertension

  • Stroke – haemorrhagic, ischaemic
  • CNS tumours
  • Severe head injury
  • Neurogenic hypertension
  • Stress – post-op pain
  • Guillain-Barré Syndrome

Hypertension in pregnancy

  • Pregnancy-induced hypertension
  • Pre-eclampsia, eclampsia

Pseudohypertension

Obstructive Sleep Apnoea

* Primary Aldosteronism includes: APA, BAH, FHI (GRA) and FHII, Adrenal Carcinoma

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