Clinical signs of secondary hypertension

Secondary causes of hypertension are uncommon and account for less than 5% of all cases of high BP in an unselected hypertensive population.

The remaining 95% of the cases have no known cause and are called idiopathic primary or essential. Secondary hypertension is usually associated with a specific organ and /or vascular abnormalities, a metabolic abnormality or endocrine disorder.

Among the sign and symptoms of secondary hypertension
*Multiple vascular risk factors, abdominal bruit, unexplained renal insufficiency, resistant hypertension
* Very high blood pressure — systolic blood pressure over 180 millimeters of mercury (mm Hg) or diastolic blood pressure over 120 mm Hg
*Proteinuria, renal dysfunction, nocturia, peripheral edema
*Hypokalemia
*Hematuria
*Daytime fatigue, sleepiness, snoring, large neck size
*Occipital headache
*Proximal weakness, diabetes, truncal obesity
*Associated nausea and vomiting
*Early onset hypertension. The documented early (less than age 30 years) or late (more than age 50 years) onset of hypertension is thought to raise the possibility of secondary forms of hypertension.
*Headache
Clinical signs of secondary hypertension

Symptoms of malignant hypertension

Malignant hypertension is a rare syndrome consisting of rapid and severe elevation of blood pressure, with then systolic component above 200 mmHg or the diastolic blood pressure greater than 140 mmHg.

Sign and symptoms of malignant hypertension include neurological changes such as anxiety, confusion, lethargy, numbness, tingling or weakness in the extremism and seizures.

The most common presentations include headaches and visual disturbances, chest pain, and dyspnea.

Other possible symptoms include nausea, vomiting and decreased urine production. Cardiac symptoms such as angina, myocardial infarction and pulmonary oedema my occasionally be the main presenting symptoms.

Malignant hypertension causes target organ damage, particularly to the kidney. The patient is likely in renal failure, indicated by the elevation in blood urea nitrogen and creatinine, the lack of urine production and the metabolite acidosis.

Persistent elevated malignant hypertension can lead to rapidly fatal course, with heart failure, myocardial infarction stroke or renal failure.
Symptoms of malignant hypertension