Speaking of secondary hypertension, not everyone has heard of it, today Dr. Zhang will explain the problems related to secondary hypertension to everyone clearly, today's article must be read by patients with hypertension at home.
Be wary of secondary hypertension
First, the number of secondary hypertension is not large?
When it comes to hypertension, it can be simply divided into two categories, one is primary hypertension and the other is secondary hypertension. The incidence of primary hypertension is about 95%, while the incidence of secondary hypertension is about 5%. According to the incidence rate, primary hypertension accounts for the vast majority, which is the hypertension that occurs in the vast majority of people. Secondary hypertension is only about 5%, and many people ignore it. However, if you do the math, you will also find that secondary hypertension is not uncommon. Authoritative data show that there are 245 million patients with hypertension in our country at this stage, according to this calculation, there are about 12.25 million patients with secondary hypertension with secondary hypertension. In this way, the number of secondary hypertension is not very large, and it is already like the sum of all the people who suffer from a small disease.
Cardiovascular disease is high
Second, what is secondary hypertension?
Secondary hypertension, also known as "symptomatic hypertension", is one of the symptoms produced by the development of certain diseases, and the elevated blood pressure when the primary disease is cured will also drop to normal. In addition to hypertension, secondary hypertension often has accompanying symptoms, such as electrolyte disorders, endocrine disorders and so on. Therefore, the harm of secondary hypertension is much greater than that of ordinary primary hypertension.
More generally speaking, high blood pressure due to secondary hypertension is only one of the symptoms of other diseases. Essential hypertension, on the other hand, is an increase in blood pressure due to a variety of causes, and there are no other diseases. Secondary hypertension often finds the primary disease, and after treating the primary disease, the hypertension can be restored. This is the essential difference between the two.
Be wary of abnormally elevated blood pressure
Third, the incidence of secondary hypertension in different populations
1. Children and adolescents
At this stage, the detection rate of hypertension in children and adolescents is 14.5%, 16.1% of boys and 12.9% of girls. For children who are overweight and obese, the detection rate of hypertension is higher, reaching 30% or more. In this population of children, once hypertension is found, the proportion of secondary hypertension is higher, and the incidence in boys is significantly higher than in girls. Therefore, after the child has high blood pressure, he must pay attention to less secondary hypertension.
2. The elderly
In addition to children, another high-incidence group of secondary hypertension is the elderly, who account for about 17% of the total incidence. However, secondary hypertension in the elderly is most easily overlooked, because hypertension in the elderly is more preconceived that it is caused by primary hypertension brought about by aging. However, the proportion of secondary hypertension in the elderly hypertension is not low, of which secondary hypertension caused by renal and renal vascular abnormalities is the most common. At the same time, there are many cases of senile hypertension that are essential hypertension and secondary hypertension, which require special attention from the elderly.
3. Hypertension in young and middle-aged people
About 5% of the hypertension in young and middle-aged people is secondary hypertension, and the common causes are renal hypertension, hypertension caused by sleep apnea, primary hyperaldosteronism and so on. For those young and middle-aged people whose blood pressure is found to be above 160/100mmHg, the effect of taking antihypertensive drugs is not good, and the blood pressure fluctuations are relatively large, Dr. Zhang Zhiying's advice is to pay attention to screening for secondary hypertension.
Fourth, what are the common causes of secondary hypertension?
There are many common causes of secondary hypertension, among which the more common ones are: renal parenchymal hypertension, renal vascular hypertension, hypertension caused by sleep apnea syndrome, primary hyperaldosteronism, pheochromocytoma, Cushing syndrome, drug-induced hypertension and so on. Specific screening for each type of secondary hypertension requires a professional doctor to perform relevant professional examinations.
V. Who should pay special attention to screening for secondary hypertension
Almost all patients with hypertension should pay attention to screening for the possibility of secondary hypertension at the beginning of the disease. At the same time, for patients with hypertension with the following characteristics, special attention should also be paid to screening for secondary hypertension: the initial hypertension is above 160/100mmHg, the effect of using antihypertensive drugs is not obvious, blood pressure fluctuations are large, and there are patients with secondary hypertension in the immediate family, accompanied by other accompanying symptoms, such as hypokalemia, renal insufficiency, full moon face, buffalo back, etc. For people with these characteristics, special attention should be paid to the possibility of screening for secondary hypertension.
Screening for secondary hypertension may involve what tests
Generally speaking, different hypertensive patients screening for secondary hypertension should be examined according to the specific situation of the patient. However, there are also some commonalities, such as ecglycogram, carotid ultrasound, biochemical total, serum potassium, plasma renin, plasma aldosterone, aldosterone/renin (ratio), cardiac ultrasound, renal, adrenal and renal artery ultrasound, urine microalbumin/urine creatinine, and multi-lead sleep monitoring. Of course, this is only some preliminary examinations, and for some people who find problems in the preliminary examination, they may further examine more professional examination items, such as adrenal gland strengthening CT, adrenal vein blood collection and so on.
7. How to treat after diagnosis?
For patients who have been clearly diagnosed with secondary hypertension, how to treat it is a big problem. However, when it comes to the treatment of secondary hypertension, Dr. Zhang can only say that the specific situation is analyzed on a case-by-case basis, and different people are different.
I hope that Dr. Zhang's introduction today can help friends in front of the mobile phone, especially those who pay attention to secondary hypertension. If you think this article is not bad, you can forward it to friends and relatives with high blood pressure.