Clinical indicators of secondary hypertension

A secondary cause of hypertension may be indicated by:

• BP lability, episodic pallor and dizziness (pheochromocytoma)
• snoring, hypersomnolence (obstructive sleep apnea)
• prostatism (chronic kidney disease due to post-renal urinary tract obstruction)
• muscle cramps, weakness (hypokalemia from primary aldosteronism or secondary aldosteronism due to renovascular disease)
• weight loss, palpitations, heat intolerance (hyperthyroidism)
• edema, fatigue, frequent urination (kidney disease or failure)
• history of coarctation repair (residual hypertension associated with coarctation)
• central obesity, facial rounding, easy bruisability (Cushing’s syndrome)
• medication or substance use (e.g., alcohol, NSAIDS, cocaine, amphetamines)
• absence of family history of hypertension (1)

Reference:

• (1) Whelton PK et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation. 2018;138(17):e426-e483.