Secondary Hypertension and How to Manage the Condition

Unlike primary hypertension, secondary hypertension has a known cause. Physicians will only diagnose the condition if a person meets certain criteria.

Man checking a woman’s blood pressure using a sphygmomanometer as they sit on a sofa

Hypertension is characterised by a higher-than-normal amount of pressure in the blood vessels. However, what isn’t normal is the onset of secondary hypertension, which has a known cause but only occurs in a small group of people. Let’s discover the reasons behind the condition, and ways to manage it effectively.

A woman closing her ears and looking at a man snoring as they both lie in bed
People with sleep apnoea are more likely to develop secondary hypertension.

Causes and Risk Factors of Secondary Hypertension in People 

A clinical diagnosis for the condition can only be provided after a person undergoes several screenings. These are typically costly and time-consuming. Hence, a physician will only order a screening if a person meets one of these criteria: 

  • Excessive weight or obesity alongside hypertension as a comorbidity 
  • Abnormally low potassium or high calcium levels in the body 
  • Hypertension that doesn’t improve, even after using three types of medications 
  • Being under the age of 30 when they were diagnosed with hypertension but have no family history of the condition 

A physician may also consider running tests if a person presents with the symptoms of an underlying condition.

Adrenal disease 

The adrenal glands are responsible for producing and regulating hormones. Problems affecting these glands can disrupt hormonal balance and provoke primary hyperaldosteronism — an increasingly prevalent trigger of secondary hypertension. Primary hyperaldosteronism refers to excess aldosterone production — a steroid hormone that influences blood pressure.

Renal disorders 

Primary hypertension can give rise to renal failure in elderly people. Subsequently, it can lead to an onset of secondary hypertension. This is evident from an elevation of serum creatinine — a waste product made by muscles — or proteinuria on a urinalysis. 

Renal parenchymal disease — a group of medical conditions that damages parts of the kidney — frequently gives rise to hypertension in pre-adolescent children. Examples of these are: 

  • Glomerulonephritis — an inflammation of kidney glomeruli 
  • Congenital abnormalities 
  • Reflux neuropathy — a backward flow of urine into the kidney  

Obstructive sleep apnoea 

Sleep apnoea is another predominant aggravator of secondary hypertension. Men who snore, are obese, or are between 40 to 59 years of age are especially vulnerable to this disorder. It’s worth noting that people with sleep apnoea will retain sodium. Therefore, their bodies will not respond to hypertensive medications. This may impair their normal circadian rhythm in blood pressure.

Use of certain medications 

People who use different types of medications may also experience side effects that make them prone to hypertension. These include:  

  • Antidepressants 
  • Decongestants 
  • Stimulants 
  • Diet pills 
  • Birth control pills 
  • Immune system suppressants 
  • Non-steroidal anti-inflammatory drugs (NSAIDs)  

Body constitution imbalances 

Traditional Chinese Medicine (TCM) believes that secondary hypertension stems from internal irregularities, such as Phlegm Dampness (痰湿), Blood Stasis (血瘀), Liver yang (active energy) Ascendant Hyperactivity (肝阳上亢), and Liver-Kidney Yin (passive energy) Deficiency (肝肾阴虚). 

Cut celery and lettuce
Eating celery or lettuce can help a person control their blood pressure.

Ways to Control Secondary Hypertension 

Taking steps to prevent secondary hypertension is a priority. It relates to a person being aware of their physical health and the potential side effects of using medications. Therefore, people should maintain an active lifestyle and consume a balanced diet. They should also speak to a physician regarding the safety of specific medications — before and after use.

Consume anti-hypertensive foods 

Physicians recommend that people with secondary hypertension must reduce their sodium intake. In addition, they may also choose to consume foods that can help lower blood pressure levels. “Celery, fungus, kelp, lettuce, spinach, corn silk, mung beans, and lotus seeds are effective anti-hypertensive foods,” explains Eu Yan Sang physician Kong Teck Chuan.

He adds, “Chrysanthemum (ju hua, 菊花), hawthorn (shan zha, 山楂), mulberries (sang ren, 桑葚), and wolfberries (gou qi, 枸杞) can also help correct the different syndromes.

Use herbal ingredients 

Herbal formulas or ingredients can alleviate hypertension by reinforcing deficiencies, calming the liver and removing Blood Stasis. This is evident from a collection of case studies, case-control studies and randomised but controlled trials.

A tian ma gou teng decoction and zhen gan xi feng decoction are frequently used to remedy these problems. Ingredients like Achyranthes (ni uxi, 牛膝), Poria (fu ling, 茯苓) and Uncaria rhynchophylla (diao gou teng, 钓钩藤) can also be used to achieve similar effects. 

Applying pressure to the shen men and si shen chong acupoints can help regulate a person’s heart rate.

Undergo acupuncture treatment 

Traditional treatment modalities like acupuncture can bring down blood pressure levels through various pathways. Stimulation of the jian shi (P5, 間使) and nei guan (P6, 內關) can support the inhibitory effects of electroacupuncture on cardiovascular responses. It does this by activating the thinly myelinated and unmyelinated fibres in the median nerve.

The use of acupuncture on points like shen men (HT7, 神門) and si shen chong (EX-HN1, 四神聰) can also slow the heart and energise the vagal nerves. These nerves belong to the parasympathetic nervous system, which controls heart rate, and digestive and immune system functions. 

Secondary hypertension can be properly managed with clinical treatment and lifestyle or dietary changes. It’s also viable to enhance blood pressure control by using herbal formulas or ingredients. Do speak to a TCM practitioner beforehand to avoid potential contraindications.

References

  1. Cleveland Clinic. Secondary Hypertension. [online] [Accessed 16 March 2022] 
  2. American Academy of Family Physicians. 2017. Secondary Hypertension: Discovering the Underlying Cause. [online] [Accessed 16 March 2022] 
  3. You and Your Hormones. Aldosterone. [online] [Accessed 16 March 2022] 
  4. Open access text. Current clinical application of traditional chinese medicine for the treatment of hypertension. [online] [Accessed 16 March 2022] 
  5. Frontiers in Aging Neuroscience. 2020. The Hypotensive Role of Acupuncture in Hypertension: Clinical Study and Mechanistic Study. [online] [Accessed 16 March 2022] 

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