Clinical Pearl Wednesday #81

Hypertension High Blood Pressure  - stevepb / Pixabay

Have a patient with hypertension? Consider secondary causes when working these patients up. Common secondary causes of hypertension include:

Obstructive sleep apnea, renal artery stenosis, alcohol abuse, NSAIDs, chronic OTC decongestant abuse, oral contraceptives, Cushing’s syndrome, and hyperaldosteronism.

I have had multiple patients who were on blood pressure medication who actually had sleep apnea. Once they started treatment for the sleep apnea, their blood pressures began to normalize, and they were able to either decrease their hypertensive medication or stop it completely.

Always have the secondary causes of hypertension in the back of your mind when you are treating your hypertensive patients vs. just prescribing them another hypertensive medication. Sometimes, there is an underlying treatable condition!

2 Responses

  1. Excessive caffeine intake, smoking, illicit drug use, incorrect BP measuring (timing, position, cuff size, selection of home BP machine). The patients are obese or overweight in most of the cases I see – thus likely to have other conditions, such as OSA, vascular damage, fatigue (thus caffeine use), joints pain (thus NSAIDs overuse) and so one, that may be causing HTN. People need to understand and admit that our normal body size in this country is not normal.

    1. 100% agree with your comment. And yes, the body size in this country is not normal. There is nothing healthy about a society where 50%+ are overweight and obese. It ABSOLUTELY contributes to HTN.

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