Definition of high blood pressure
What to do in case of hypertension?
For a better understanding of blood pressure The follow-up of a high blood pressure
High blood pressure damage High blood pressure and special cases
Why does high blood pressure exist? The self-measurement of blood pressure
How to measure high blood pressure? About Us
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IV - Why does high blood pressure exist?

4.1 - Most of the time, there is no explanation for this high blood pressure
But sometimes a disease is responsible for hypertension:
the secondary arterial hypertensions

4.2 - The medical procedure
4.3 - Causes
        4.3.1 - Drugs
        4.3.2 - An hormonal disorder

        4.3.3 - High blood pressure induced by the kidney
        4.3.4 - A rare cause: presence of an obstacle in the aorta

4.2 - The medical procedure

A secondary high blood pressure disease will be investigated by the doctor only when the blood pressure is very high, and in the presence of characteristic symptoms.


The doctor’s search for the reasons for the high blood pressure will be guided by the circumstances of its discovery. High blood pressure can be observed in a context of emergency, with very high levels of blood pressure (minima > 140 mmHg), associated with clinical signs of bad tolerance especially neurological (confusion, somnolence, stupor, signs of neurological deficit), cardiac (cardiac insufficiency), renal (renal insufficiency) and gastro-intestinal (nauseas, vomiting).

This serious situation is extremely rare but can reveal a secondary cause of high blood pressure such as a disease of the vessels, a scleroderma or a disease of the renal artery.

We will not consider the particular case of the crisis of high blood pressure occurring in a pregnant woman having the diagnosis of ”gravid arterial hypertension ”.

During the medical consultation the doctor will ask his patient if they are:

  • Taking any pills or medicines, which could be potentially responsible for the high blood pressure such as: contraceptive pill, nasal spray to clear the nose, cortisone, consumption of liquorice, anti-inflammatory drug.

  • A history of kidney disease with episodes of blood or proteins in the urine is looked for. For an African patient or another patient having stayed in Africa, the practitioner will consider parasites that locate themselves in urine or urinary tract (the bilharzias).

  • A family history of kidney disease and kidney multifoiled will be required because these congenital diseases can be responsible of high blood pressure.

A rigorous clinical examination carried out by the doctor who will be looking for:

  • A tall size or excessive growth is evocative of a disease called acromegalia. A deformed syndrome with obesity, a puffy face and rather thin legs is evocative of an excess of cortical secretion (Cushing syndrome).

  • The blood pressure measurement is done at the arms, and the doctor looks for an asymmetry (inequality of blood pressure between the two arms) evocative of an obstacle on the artery.

  • The palpation of the lumbar area will be used to detect an increased volume of the kidney, to search a polycystic kidney if the doctor perceives only one kidney with a high volume. A chronic renal disease can also be evocated if the size of the two kidneys is increased.

  • With his stethoscope, the physician hears the aorta at the level of the belly tracking a rare but evocative breath, in favour of a coarctation of the aorta. This disease is induced by a narrowing of the aorta, which prevents the normal passage of the blood and thus causes a hyperpression in the arteries of the upper limbs, whereas there is a hypotension in the arteries of the lower limbs.

    The physician also searches for an abdominal murmur indicating an obstruction of the renal artery.

At the end of the consultation, a few examinations must be carried out: a pulmonary radiography, searching for an aorta coarctation, a blood test and an abdominal echography searching for a kidney disease.

File last reviewed on : 18 dec 2011
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