Secondary hypertension is a hypertensive disorder, the cause of other basic diseases. This is by 5 to 15% of all high-pressure patients. The treatment of the underlying disease plays in the therapy in addition to lowering blood pressure an important role. The most common causes of secondary hypertension are diseases of the kidneys, the endocrine system and blood vessels. The frequency data is to be specified with significant differences.
Kidney disease is the most common cause of secondary hypertension: We distinguish between diseases of the renal arteries and the renal tissue. Diseases of the kidney tissue (renoparenchymatic form) are due to chronic inflammation (glomerulonephritis, interstitial nephritis), caused by diabetic damage (nephropathy) or cystic kidneys. This has a diminished ability pathogenesis of salt excretion and thus an increase in blood pressure result.
The narrowing of the renal artery, which is known as renovascular form as well as Fibromuscular dysplasia, or inflammation caused by atherosclerosis, connective tissue disease. Thus the kidney is insufficient blood supply, which activates the renin-angiotensin-aldosterone system (RAAS). This results in vasoconstriction, activation of the sympathetic nervous system and reduced salt excretion in the kidney, which in turn lead to an increased blood volume. All these mechanisms contribute) to an increase in blood pressure (Goldblatt mechanism. Treatment of renovascular hypertension is the narrowing of the arteries dilate) using a catheter (angioplasty. If there is a stenosis, however, over time can, through the resulting is Secondary hypertension, even after such treatment persist renal fixation.
Disturbances in hormone levels may be caused by a number of different diseases. With a Conn’s syndrome, an increased aldosterone levels lead to activation of the renin-angiotensin-aldosterone system. The newer version (with normal potassium levels) of Conn’s syndrome may represent more recent studies suggest that a large proportion of secondary hypertension. It is causing the case of a pheochromocytoma excessive adrenaline – and norepinephrine production in activation of the sympathetic nervous system, in a Cushing’s syndrome because the increased corticosteroid hormones increased absorption in the kidney. Other, less common causes are an adrenogenital syndrome, an acromegaly (increased growth hormone production) and hyperparathyroidism) (overactive parathyroid glands.
In a coarctation of the aorta (congenital malformations of the aorta), a narrowing of the aorta is the aortic arch, ie the curvature of the aorta above the heart. With this narrowing of the blood pressure rises. By the decreased blood flow to the kidneys, which lie below this bottleneck, it comes through the same mechanisms as in renal artery stenosis in arterial hypertension.
Sleep apnea occurs through the sympathicotonic awake reactions occurring in a particular increase in blood pressure that occur at night. By the treatment of sleep apnea syndrome (CPAP) improves the hypertension usually clear.
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