Kidney disease / renal artery stenosis – the normal physiological response to low blood pressure in the renal arteries is to increase cardiac output (CO) to maintain the pressure needed for glomerular filtration. Here, however, increased CO cannot solve the structural problems causing renal artery hypotension, with the result that CO remains chronically elevated.
Neurogenic hypertension – excessive secretion of norepinephrine and epinephrine which promotes vasoconstriction resulting from chronic high activity of the sympathoadrenal system, the sympathetic nervous system and the adrenal gland. The specific mechanism involved is increased release of the "stress hormones", epinephrine (adrenaline) and norepinephrine which increase blood output from the heart and constrict arteries. People with neurogenic hypertension respond poorly to treatment with diuretics as the underlying cause of their hypertension is not addressed.
Pheochromocytoma – a tumor which results in an excessive secretion of norepinephrine and epinephrine which promotes vasoconstriction
A variety of adrenal cortical abnormalities can cause hypertension, In primary aldosteronism there is a clear relationship between the aldosterone-induced sodium retention and the hypertension.
Congenital adrenal hyperplasia, a group of autosomal recessive disorders of the enzymes responsible for steroid hormone production, can lead to secondary hypertension by creating atypically high levels of mineralocorticoid steroid hormones. These mineralocorticoids cross-react with the aldosterone receptor, activating it and raising blood pressure.
17 alpha-hydroxylase deficiency causes an inability to produce cortisol. Instead, extremely high levels of the precursor hormone corticosterone are produced, some of which is converted to 11-Deoxycorticosterone (DOC), a potent mineralocorticoid not normally clinically important in humans. DOC has blood-pressure raising effects similar to aldosterone, and abnormally high levels result in hypokalemic hypertension.
Cancers: tumours in the kidney can operate in the same way as kidney disease. More commonly, however, tumors cause inessential hypertension by ectopic secretion of hormones involved in normal physiological control of blood pressure.
White coat hypertension, that is, elevated blood pressure in a clinical setting but not in other settings, probably due to the anxiety some people experience during a clinic visit.
Perioperative hypertension is development of hypertension just before, during or after surgery. It may occur before surgery during the induction of anesthesia; intraoperatively e.g. by pain-induced sympathetic nervous system stimulation; in the early postanesthesia period, e.g. by pain-induced sympathetic stimulation, hypothermia, hypoxia, or hypervolemia from excessive intraoperative fluid therapy; and in the 24 to 48 hours after the postoperative period as fluid is mobilized from the extravascular space. In addition, hypertension may develop perioperatively because of discontinuation of long-term antihypertensive medication.
Medication side effects
Certain medications, including NSAIDs (Motrin/Ibuprofen) and steroids can cause hypertension. Other medications include extrogens (such as those found in oral contraceptives with high estrogenic activity), certain antidepressants (such as venlafaxine), buspirone, carbamazepine, bromocriptine, clozapine, and cyclosporine.
High blood pressure that is associated with the sudden withdrawal of various antihypertensive medications is called rebound hypertension. The increases in blood pressure may result in blood pressures greater than when the medication was initiated. Depending on the severity of the increase in blood pressure, rebound hypertension may result in a hypertensive emergency. Rebound hypertension is avoided by gradually reducing the dose (also known as "dose tapering"), thereby giving the body enough time to adjust to reduction in dose. Medications commonly associated with rebound hypertension include centrally-acting antihypertensive agents, such as clonidine and methyl-dopa.
Other herbal or "natural products" which have been associated with hypertension include ma huang, St John's wort, and licorice.
^Giacchetti G, Turchi F, Boscaro M, Ronconi V (April 2009). "Management of primary aldosteronism: its complications and their outcomes after treatment". Current Vascular Pharmacology. 7 (2): 244–49. doi:10.2174/157016109787455716. PMID19356005.
^Ziaja J, Cholewa K, Mazurek U, Cierpka L (2008). "[Molecular basics of aldosterone and cortisol synthesis in normal adrenals and adrenocortical adenomas]". Endokrynologia Polska (in Polish). 59 (4): 330–39. PMID18777504.
^Astegiano M, Bresso F, Demarchi B, et al. (March 2005). "Association between Crohn's disease and Conn's syndrome. A report of two cases". Panminerva Medica. 47 (1): 61–4. PMID15985978.
^Pereira RM, Michalkiewicz E, Sandrini F, et al. (October 2004). "[Childhood adrenocortical tumors]". Arquivos Brasileiros de Endocrinologia e Metabologia (in Portuguese). 48 (5): 651–58. doi:10.1590/S0004-27302004000500010. PMID15761535.
^Kievit J, Haak HR (March 2000). "Diagnosis and treatment of adrenal incidentaloma. A cost-effectiveness analysis". Endocrinology and Metabolism Clinics of North America. 29 (1): 69–90, viii–ix. doi:10.1016/S0889-8529(05)70117-1. PMID10732265.
^Kumar, Abbas, Fausto. Robbins and Cotran Pathologic Basis of Disease, 7th ed. Elsevier-Saunders; New York, 2005.
^Yudofsky, Stuart C.; Robert E. Hales (2007). The American Psychiatric Publishing Textbook of Neuropsychiatry and Behavioral Neurosciences (5th ed.). American Psychiatric Pub, Inc. ISBN978-1-58562-239-9.
^van Zwieten PA, Thoolen MJ, Timmermans PB (1984). "The hypotensive activity and side effects of methyldopa, clonidine, and guanfacine". Hypertension. 6 (5 Pt 2): II28–33. doi:10.1161/01.hyp.6.5_pt_2.ii28. PMID6094346.
^Kang A, Struben H (November 2008). "[Pre-eclampsia screening in first and second trimester]". Therapeutische Umschau. Revue Thérapeutique (in German). 65 (11): 663–66. doi:10.1024/0040-59184.108.40.2063. PMID18979429.
^Williams B et al.; British Hypertension Society; Michael Sutters, MD (2006). "Secondary Hypertension". Hypertension Etiology & Classification - Secondary Hypertension. Armenian Medical Network. Retrieved 2 December 2007.CS1 maint: uses authors parameter (link)