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Clinical indicators of secondary hypertension

Last edited 3 Nov 2018. Last reviewed 31 Jul 2021

Authoring team

A secondary cause of hypertension may be indicated by:

BP lability, episodic pallor and dizziness (pheochromocytoma)
snoring, hypersomnolence (obstructive sleep apnea)
prostatism (chronic kidney disease due to post-renal urinary tract obstruction)
muscle cramps, weakness (hypokalemia from primary aldosteronism or secondary aldosteronism due to renovascular disease)
weight loss, palpitations, heat intolerance (hyperthyroidism)
edema, fatigue, frequent urination (kidney disease or failure)
history of coarctation repair (residual hypertension associated with coarctation)
central obesity, facial rounding, easy bruisability (Cushing’s syndrome)
medication or substance use (e.g., alcohol, NSAIDS, cocaine, amphetamines)
absence of family history of hypertension (1)

Reference:

(1) Whelton PK et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation. 2018;138(17):e426-e483.

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