Causes of Hypertension

The common causes of hypertension at different ages are given in Table 22-22. A more comprehensive list of the causes of hypertension is given in Tables 22-23 and 22-24.

For convenience these have been divided into hypertension that is associated with another, usually obvious disease (Table 22-23), is often acute, and subsides when the associated disease is cured, and sustained hypertension that often cannot be diagnosed by a preliminary history and examination and is usually secondary to renal or endocrine disorders (Table 22-24).

AGE-RELATED COMMON CAUSES OF HYPERTENSION AGE GROUP LESIONS

Neonate

Renal artery thrombosis or stenosis, renal malformations, coarctation of the aorta, bronchopulmonary dysplasia

Infants to 6 years

Renal parenchymal diseases, coarctation of the aorta, renal artery stenosis

6-10 years

Renal parenchymal diseases, renal artery stenosis, essential hypertension

Adolescence

Essential hypertension, obesity, renal parenchymal diseases

CAUSES OF HYPERTENSION (OFTEN ACUTE) ASSOCIATED WITH OTHER DISORDERS

Nervous system disorders

• Encephalitis, meningitis
• Raised intracranial pressure
• After intracranial surgery or cranial trauma
• Poliomyelitis; Guillain-Barre syndrome
• Familial dysautonomia
• Severe emotional stress

Acute renal disease

• Acute glomerulonephritis
  
• Hemolytic-uremic syndrome
  
• Acute pyelonephritis
  
• Renal vein thrombosis
  
• Vasculitides
  
• Transplant rejection

Metabolic disorders

• Hypernatremia
  
• Hypercalcemia
  
• Acute intermittent porphyria
  
• Steroid ingestion (contraceptive pills with estrogen, anabolic steroids, therapeutic)

Drug abuse