Why does high blood pressure exist?
- Most of the time, there is no explanation for this high blood pressure
But sometimes a disease is responsible for
the secondary arterial hypertensions
4.2 - The
4.3 - Causes
- An hormonal disorder
- High blood pressure induced by the kidney
- A rare cause: presence of an obstacle in the aorta
4.2 - The
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 doctors 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,
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
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.
last reviewed on : 18 dec 2011