Secondary hypertension results from an identifiable cause. Kidney disease is the most common secondary cause of hypertension.[23] Hypertension can also be caused by endocrine conditions, such as Cushing's syndrome, hyperthyroidism, hypothyroidism, acromegaly, Conn's syndrome or hyperaldosteronism, renal artery stenosis (from atherosclerosis or fibromuscular dysplasia), hyperparathyroidism, and pheochromocytoma.[23][47] Other causes of secondary hypertension include obesity, sleep apnea, pregnancy, coarctation of the aorta, excessive eating of liquorice, excessive drinking of alcohol, and certain prescription medicines, herbal remedies, and illegal drugs such as cocaine and methamphetamine.[23][48] Arsenic exposure through drinking water has been shown to correlate with elevated blood pressure.[49][50]
The new guidelines note that blood pressure should be measured on a regular basis and encourage people to use home blood pressure monitors. Monitors can range from $40 to $100 on average, but your insurance may cover part or all of the cost. Measure your blood pressure a few times a week and see your doctor if you notice any significant changes. Here are some tips on how to choose and use a monitor.
Orthostatic hypotension is caused by a sudden change in body position. This occurs most often when you shift from lying down to standing. This type of low blood pressure usually lasts only a few seconds or minutes. If this type of low blood pressure occurs after eating, it is called postprandial orthostatic hypotension. This type most often affects older adults, those with high blood pressure, and people with Parkinson disease.
On physical examination, hypertension may be associated with the presence of changes in the optic fundus seen by ophthalmoscopy.[22] The severity of the changes typical of hypertensive retinopathy is graded from I to IV; grades I and II may be difficult to differentiate.[22] The severity of the retinopathy correlates roughly with the duration or the severity of the hypertension.[20]
Echocardiogram is an ultrasound examination of the heart It is used to evaluate the anatomy and the function of the heart. A cardiologist is required to interpret this test and can evaluate the heart muscle and determine how thick it is, whether it moves appropriately, and how efficiently it can push blood out to the rest of the body. The echocardiogram can also assess heart valves, looking for narrowing (stenosis) and leaking (insufficiency or regurgitation). A chest X-ray may be used as a screening test to look for heart size, the shape of the aorta, and to assess the lungs.
Pre-eclampsia is a serious condition of the second half of pregnancy and following delivery characterised by increased blood pressure and the presence of protein in the urine.[23] It occurs in about 5% of pregnancies and is responsible for approximately 16% of all maternal deaths globally.[23] Pre-eclampsia also doubles the risk of death of the baby around the time of birth.[23] Usually there are no symptoms in pre-eclampsia and it is detected by routine screening. When symptoms of pre-eclampsia occur the most common are headache, visual disturbance (often "flashing lights"), vomiting, pain over the stomach, and swelling. Pre-eclampsia can occasionally progress to a life-threatening condition called eclampsia, which is a hypertensive emergency and has several serious complications including vision loss, brain swelling, seizures, kidney failure, pulmonary edema, and disseminated intravascular coagulation (a blood clotting disorder).[23][31]
Wear a blood pressure monitor. This monitor is attached to you. You will be asked to wear it for 24 hours. The monitor is usually programmed to take blood pressure readings every 15 to 30 minutes all day and night while you go about your normal activities. The doctor will evaluate the results. In some cases, home blood pressure monitors may also be used to evaluate the effectiveness of your treatment.

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Recognizing heart attack symptoms and signs can help save your life or that of someone you love. Some heart attack symptoms, including left arm pain and chest pain, are well known but other, more nonspecific symptoms may be associated with a heart attack. Nausea, vomiting, malaise, indigestion, sweating, shortness of breath, and fatigue may signal a heart attack. Heart attack symptoms and signs in women may differ from those in men.
Stage 1 and Stage 2 hypertensions require therapy with anti-hypertensive drugs to bring down the blood pressure. Lifestyle modifications are also necessary, but often it is not sufficient for satisfactory control of blood pressure. Hypertension is often asymptomatic in the early course of disease. Symptoms like headache, lightheadedness, palpitations and easy fatigability may occur and chances of them being present increases with increasing blood pressure.
To make an official diagnosis of high blood pressure you will need to see your doctor. Often your blood pressure will be checked on at least two different visits, at different times of the day. Your doctor may ask you to keep a blood pressure log for a short time in order to see your overall blood pressure trends. If your blood pressure is consistently over 134/80, your doctor will work with you to determine the best regimen for treating your high blood pressure.
Postural hypotension occurs most frequently in people who are taking drugs to control high blood pressure (hypertension). It can also be related to pregnancy, strong emotions, hardening of the arteries (atherosclerosis), or diabetes. The elderly are particularly affected, especially those who have high blood pressure or autonomic nervous system dysfunction.
Stage 1 and Stage 2 hypertensions require therapy with anti-hypertensive drugs to bring down the blood pressure. Lifestyle modifications are also necessary, but often it is not sufficient for satisfactory control of blood pressure. Hypertension is often asymptomatic in the early course of disease. Symptoms like headache, lightheadedness, palpitations and easy fatigability may occur and chances of them being present increases with increasing blood pressure.
The primary symptoms of malignant hypertension is a blood pressure of 180/120 or higher and signs of organ damage. Other symptoms of malignant hypertension include bleeding and swelling of blood vessels in the retina, anxiety, nosebleeds, severe headache, and shortness of breath. Malignant hypertension may cause brain swelling, but this symptom is very rare.
Being overweight increases the risk of getting hypertension and increases the workload required of your heart. Diets designed to control blood pressure are often designed to reduce calories as well. Most of these diets require decreasing consumption of fatty foods and sugars while increasing your intake of lean protein, fiber, fruits, and vegetables. A weight loss of just 10 pounds can make a significant difference in your blood pressure.
Your doctor can help you measure and track your blood pressure to confirm whether it’s too high. You may need to start taking medications if your blood pressure doesn’t improve after one month of following a healthy lifestyle, especially if you’re already at high risk for heart disease. If you’re at lower risk, your doctor may want to follow up in three to six months after you’ve adopted more healthy habits.
The measurements must have been obtained from at least two careful readings on at least two different occasions. What does careful mean? The guidelines provide a six-step tutorial on how, exactly, to correctly measure a blood pressure, which, admittedly, is sorely needed. My patients often have their first blood pressure taken immediately after they have rushed in through downtown traffic, as they’re sipping a large caffeinated beverage. While we always knew this could result in a falsely elevated measurement, it is now officially poor clinical technique resulting in an invalid reading.
This study is assessing whether a low-sodium and low-calorie eating pattern, along with aerobic exercise, can improve blood pressure in patients who do not respond to high blood pressure medicines. To participate you must be at least 35 years and have high blood pressure that does not respond to medicines. Please note that this study is in Durham, North Carolina.
Hypertension does not usually cause any noticeable symptoms. When it does, you might experience dizziness, shortness of breath, headaches, and nosebleeds, which could indicate that your blood pressure is rising. Complications such as heart disease, stroke, and kidney failure can occur if long-term hypertension is not adequately treated. A hypertensive emergency, which is an uncommon and dangerous event, may cause blurry vision, nausea, chest pain and anxiety.
tilt table test – usually recommended if your doctor suspects you might have orthostatic hypotension or NMH (During this diagnostic test, a person lies on a table and then the table is tilted to raise the upper part of their body. This simulates the change in position from sitting or lying down to standing up. People with orthostatic hypotension or NMH may feel dizzy, lightheaded, or even faint when their position changes.)
If diet and exercise are not sufficient to lower blood pressure, the first medications recommended are often diuretics or so-called "water pills." These reduce sodium and fluid levels in the body to lower blood pressure. Taking diuretics means you will urinate more frequently. Sometimes, diuretics deplete potassium levels as well, which can lead to muscle weakness, leg cramps, and tiredness. Other side effects of diuretics can include elevated blood sugars in people with diabetes. Less commonly, erectile dysfunction can occur.

"The implications and potential benefits of such healthier lifestyles could be great, particularly since about 22% of the adult population falls into the prehypertensive category," says Chobanian, who is also dean of the Boston University School of Medicine. "In fact, the blood pressure effects of weight reduction or adoption of the DASH eating plan can be comparable to those achieved with any single blood pressure medication."
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