Hypertension is a pathology associated with chronic high blood pressure. In turn, this disease is divided into two types: primary and secondary arterial hypertension. The first type occurs as a result of disruption of blood vessels, the second is a consequence of some diseases in different body systems. The first type of hypertension is much more common than the other - secondary hypertension, which requires not only therapy of the vascular system, but also those organs, the violation of which provoked an increase in pressure. In the article, we will examine in more detail the symptoms, causes and classification of the disease.
What it is
Symptomatic arterial hypertension or, in another way, secondary is observed with damage to internal systems and organs. An increase in blood pressure often occurs against a background of chronic diseases that from time to time remind of oneself. Primary hypertension is difficult to diagnose. What can not be said about the symptomatic form of pathology. The causes of it are quickly clarified thanks to the international classification of diseases, in which you can find all the information about secondary hypertension (according to ICD 10, l15 - its code in the system).
Symptoms
In the international classification, you can find the following symptoms of the disease:
- dizziness;
- headaches;
- "flies" before the eyes;
- rapid pulse;
- noise in ears;
- swelling, especially in the morning;
- irritability;
- sense of anxiety;
- weakness;
- nausea.
Both primary and secondary hypertension have a common symptom - this is high blood pressure. With a symptomatic form, not all signs of pathology may appear. Sometimes it can be manifested only by increased pressure. The most pronounced signs can be seen in patients with neurogenic hypertension. In this case, convulsions, sweating and tachycardia may additionally be observed.
If the increase in pressure is caused by problems in the functioning of the renal system, then the patient has visual impairment and headaches. At the beginning of the development of the disease, the pathological process may not make itself felt. A person may feel a slight malaise, which most attribute to fatigue. Although at this moment a dangerous ailment arises, which must be treated in a timely manner.
Every person suffering from chronic diseases must be familiar with the signs inherent in secondary hypertension. Thanks to this knowledge, he will be able to protect himself from dangerous complications, which can lead to frequent cases of high blood pressure.
It is important to learn to distinguish the primary form from the secondary. The latter has some features:
- traditional remedies do not help relieve pressure;
- Blood pressure rises suddenly;
- violation is characteristic of young people from 20 years of age and pensioners after 60 years;
- elevated blood pressure is persistent;
- sympatho-adrenaline crises may occur.
An accurate diagnosis can only be made by a specialist after examining a person who has complained of ill health.
A distinctive feature of the secondary form of the disease is the inability to reduce pressure with conventional drugs.
Classification
Secondary hypertension, according to the classification of ICD-10, has several different types, depending on the etiology. These include:
- Renovascular hypertension
- caused by endocrine disorders;
- due to other factors;
- associated with kidney damage;
- unspecified.
Causes
The causes of secondary hypertension are divided into several groups. They depend on what disease provoked an increase in pressure:
- In renal hypertension - stagnation of fluid in the body, impaired blood flow in the kidneys and narrowing of the arteries.
- With endocrine hypertension - acromegaly, adrenal gland disease, thyroid problems.
- With the neurogenic form - encephalitis, trauma, stroke, increased intracranial pressure, brain tumors.
- With a cardiovascular form - heart defects, aortic damage, heart failure.
- The dosage form of hypertension arises during the administration of antidepressants, oral contraceptives with estrogens, glucocorticoids.
- A frequent cause of high blood pressure is alcohol abuse, so chronic alcoholism can be attributed to the pathology.
Pulmonary hypertension
Secondary pulmonary hypertension is a pathology in which pressure in the arteries of the lungs rises. The result is a narrowing of the lumen in the vessel of the lung. The reason for this is the complex structure of the pulmonary arteries. The disease most often occurs in middle-aged women. In men, it is diagnosed three times less.
At the first stages, the disease does not manifest itself in any way, a person may not even be aware of its presence until there is a hypertensive crisis, hemoptysis, and pulmonary edema. That is, when the development of secondary pulmonary hypertension takes a severe form, and this greatly complicates the treatment.
Renal
The renal form of the disease is considered the most common. It is found in the vast majority of cases, more than 80%. Pathology develops due to damage to the kidneys, which can be either congenital or acquired, as well as with pathologies of the arteries that feed the kidneys.
How severe the disease will be depends on how quickly the renal artery becomes clogged and how the disease itself occurs, which caused an increase in blood pressure. At the initial stages, there may not be signs of hypertension.
Secondary renal hypertension will begin to manifest itself only after a severe damage to the kidney tissue occurs. Patients with a diagnosis of pyelonephritis are afraid of an increase in blood pressure. With inflammation in the renal pelvis, the risk of pressure problems is very high. Glomerulonephritis can lead to the same diagnosis. This disease is also contagious.
Often you can see symptomatic hypertension in young patients. If the pathology is not cured in time, then the development of renal failure is inevitable. It is also worth noting that with infectious forms of the disease, the risk of severe hypertension is 12%.
Endocrine hypertension
This form of secondary hypertension develops amid problems with the endocrine glands. Often, pathology is diagnosed in people with thyrotoxicosis. This is a thyroid disease, which is expressed as an increased secretion of the hormone thyroxine. With such a violation, an increase in systolic pressure is observed, and diastolic blood pressure is normal.
Diseases of the endocrine system in which hypertension develops:
- Feochromocytoma: the main sign of an adrenal tumor is an increase in blood pressure. In this disease, the pressure is either stably high or paroxysmal.
- Conn's syndrome: due to the increased release of the hormone aldosterone in the body, sodium begins to linger, and a secondary form of hypertension develops.
- Itsenko-Cushing's syndrome. Most patients with this pathology suffer from high blood pressure. It is recognized by specific changes in the body: the body becomes denser, and the face is puffy. In this case, the limbs remain normal.
- Climax During the extinction of female sexual functions, jumps in blood pressure often occur.
The endocrine form of hypertension responds well to therapy, if you start it in a timely manner.
Neurogenic hypertension
This form of symptomatic hypertension occurs against a background of diseases of the central nervous system. High blood pressure is not the only symptom indicating neurogenic hyperplasia. There are a few more signs:
- sweating
- cramps
- skin rashes;
- dizziness;
- tachycardia;
- headache.
Treatment of neurogenic hypertension is based on the elimination of brain pathologies.
Hemodynamic hypertension
Diseases of the cardiovascular system lead to a secondary hemodynamic form of hypertension. These include:
- atherosclerosis;
- mitral valve disease;
- heart failure;
- narrowing of the aorta;
- systolic hypertension.
As a rule, none of these pathologies is the only cause of increased pressure. Most often, the disease develops against the background of two pathological processes. For example, renal artery stenosis and a chronic form of pyelonephritis.
Drug hypertension
Improper medication can also trigger high blood pressure. Certain groups of drugs have this pathology in the list of side effects and complications. With this form of hypertension, pressure surges can be paroxysmal or protracted.
Such reactions result from the use of the following drugs:
- anti-inflammatory non-steroidal agents;
- oral contraceptives;
- Cyclosporin.
With prolonged use of such medications, the patient may worsen. It also threatens the development of extensive brain pathologies.
Diagnostics
Diagnostic studies of secondary arterial hypertension consist of several standard procedures. Pathology is recognized by systolic and systolodiastolic murmurs that can be heard in the epigastric region. Such a symptom most often indicates the presence of renal artery stenosis.
In order to measure pressure, the patient must be in a standing position, and then lying down. Indicators are measured in two states: first at rest, and then at the end of physical activity. Due to the difference between blood pressure indicators, a specialist determines a number of secondary symptoms that occur with this type of hypertension.
The following procedures are also performed: ultrasound, scintigraphy, dopplerography and the condition of the arteries is studied. If renal hypertension is suspected, additional tests and studies may be prescribed. Be sure to give up blood, urine and a tank test, indicating a bacterial infection. In some forms of secondary hypertension, CT and MRI can be prescribed. If a tumor develops in the body, a biopsy is mandatory.
With any type of symptomatic hypertension, a referral to an ophthalmologist is issued. This is due to the fact that pathology can lead to damage to the eye retina.
Treatment
The treatment of hypertension does not always go as standard. The specialist cannot prescribe drugs that will help reduce blood pressure, since they will not give the desired effect. In order to get rid of symptomatic hypertension, it is necessary to act on the root cause, which affects the increase in blood pressure.
As a rule, there are two types of therapy: in the uncomplicated course of the disease, medication is prescribed, and in the severe course, one has to deal with the disease in more radical ways, including through surgery.
Drug treatment
For the treatment of symptomatic hypertension, medication is most often prescribed. In some cases, it is combined with surgical intervention. Therapy with drugs helps to reduce the number of attacks of hypertension, normalize blood pressure and prolong remission. For this, such drugs are prescribed as:
- "Moxonidine" and similar antihypertensive agents.
- "Verapamil", "Kordafen" are calcium channel antagonists.
- "Enalapril", "Fosinopril" - ACE inhibitors.
- "Timolol", "Pindolol" - beta blockers.
Medications give a positive effect when combined with each other, only a doctor can prescribe a complex for admission, after all examinations have been completed.
Surgical intervention
This type of treatment is used if during the diagnostic study malignant or benign formations that cause high blood pressure were detected. For each patient, based on the medical history, their individual treatment is used. It all depends on the age of the patient, the nature of the pathology and its severity.
Prevention and prognosis
Prevention of secondary arterial hypertension is aimed at preventing the disease that caused the pathology, or at preventing the development of hypertension against the background of an existing disease. The main measures are aimed at maintaining a healthy lifestyle:
- proper nutrition;
- body weight control;
- quitting alcohol and smoking;
- in the presence of a predisposition to diseases leading to secondary hypertension, it is necessary to regularly undergo examinations with specialized doctors.
Another preventive measure is the constant monitoring of blood pressure in an existing disease, and its timely correction.
Constant high blood pressure is a serious disease if you do not fight it. Secondary arterial hypertension, as a rule, passes along with the pathology that caused it. That is why it is important to find the root cause of high pressure. This may take some time. But the effectiveness of further therapy depends on the correct diagnosis.