What is it about ?
In case of increased blood pressure (hypertension), we must distinguish primary hypertension from secondary. Of 100 people with high blood pressure, 90 to 95 have hypertension for which no specific cause is found (primary hypertension) and 5 have hypertension due to an underlying condition, that is, other disease is causing the rise in blood pressure (secondary hypertension).
Elements that may indicate secondary hypertension are:
- onset before the age of 30,
- blood pressure that does not drop despite treatment with several drugs,
- systolic blood pressure of more than 220 mmHg and / or diastolic blood pressure of more than 120 mmHg,
- blood pressure at an older age which increases rapidly,
- proteinuria or hematuria (protein and blood in the urine),
- hypokalaemia (low level of potassium) or abnormal kidney tests in the blood.
The most common causes are:
- kidney disease: abnormalities in the kidney or even in the blood vessels that supply the kidney with blood (renovascular hypertension);
- hormonal disorders: diseases related to the adrenal glands, thyroid and parathyroid glands with increased production of hormones;
- certain drugs / foods / narcotics: oral contraceptives (the pill), anabolics, anti-inflammatories, ciclosporin, tacrolimus, cortisone, certain antidepressants, alcohol, cocaine, amphetamine, excessive consumption of licorice and licorice;
- breathing pauses (Sleep Apnea);
- narrowing of a main artery (for example, coarctation of the aorta).
What is its frequency?
An underlying condition is found in about 5 in 100 people who have high blood pressure.
How to recognize it?
Usually, you don’t feel like you have high blood pressure. At very high values, you may experience headaches in the back of the skull (at the level of the occiput), feel tired more quickly and be more suddenly short of breath. In secondary hypertension, you may have symptoms related to the condition that is at the root of the hypertension, such as general weakness, nausea, of the constipation, palpitations or hot flashes.
How is the diagnosis made?
If your doctor repeatedly measures high blood pressure and suspects secondary hypertension, he will schedule a number of tests to determine the cause: a urine and blood test, an ultrasound of the kidneys, a fluoroscopy of the vessels. blood, etc. If in doubt, it is also possible to take a kidney biopsy (a small piece of kidney tissue is removed for analysis).
What can you do ?
Adopt from a healthy lifestyle is important: do not eat too much sugar or too much fat, limit your alcohol intake, watch your weight, exercise enough and do not smoke. Also limit the intake of salt; your body only needs about 6 grams per day. There is already enough salt in an ordinary diet. Therefore, there is no need to add salt to what you eat.
Take your medication as best you can.
What can your doctor do?
The doctor will treat both the underlying condition and the hypertension. The target blood pressure (i.e. where it should be) is around 130/80 mmHg. The underlying condition (that is, the disease that causes blood pressure to rise) is often treated with surgery (that is, surgery on blood vessels, kidneys, adrenal glands, thyroid or parathyroid glands).
Medicines against hypertension are added gradually: we start with a single product. If the result is insufficient, a second and, if necessary, a third is added. If the blood pressure still does not drop enough, it is sometimes necessary to seek the advice of a kidney specialist (nephrologist).
Want to know more?
- Eating and gaining years of life is possible! (video) – CSS – Superior Health Council
- Salt: just a grain – mongeneraliste.be – SSMG – Scientific Society of General Medicine
- Salt: pay attention to industrial preparations – SSMG – Scientific Society of General Medicine
- The food pyramid – Eat Move – Health Question
- Nutri-Score – SPF Public health, food chain safety and the environment
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