Rare Causes of Hypertension
Most likely you’ve heard about a condition called hypertension or high blood pressure. Nowadays, it is very common in a mature age group, and is so common that it has became the norm. Many people regard it as a sign of aging since the majority of their friends and relative seem to suffer from it.
However, people should be aware of the fact that high blood pressure is a sign that your circulatory system is overloaded. This can be caused by a number of factors, most common of which are obesity and atherosclerosis. Atherosclerosis makes the arteries stiff and then it is difficult for the heart to push the blood through. This causes the heart to work extra hard, causing the blood pressure to rise. Obesity, on the other hand, not only promotes the development of atherosclerosis, it also causes the visceral fat to compress the kidneys, making them produce renin (a hormone which raises blood pressure).
High blood pressure is a dangerous condition but it is very common for people to forget just how dangerous it really is. Moreover, even if people notice that their blood pressure is elevated, they are most likely to just disregard it and continue as before. Taking such an approach can be very detrimental to your health since blood pressure is merely a symptom of an underlying condition. High blood pressure seems to be common and widespread, but when combined with atherosclerosis or obesity, these conditions can be very serious and life-threatening.
Pheochromocytoma
Pheochromocytoma is a neuroendocrine tumor of the adrenal medulla. This causes the adrenal glands to secrete high amounts of norepinephrine and epinephrine. One of the most common symptoms of this condition is high blood pressure, reaching as much as 200 mmHg. This leads to the second most common symptom – headaches. Since these headaches are caused by high blood pressure, the pain that they cause is usually throbbing and located in the back of the skull.
Other common symptoms include skin sensations, elevated heart rate, palpitations, anxiety, pallor, weight loss, and high blood glucose levels.
Pheochromocytoma can result in resistant arterial hypertension – a hypertension that cannot be treated using common drugs. In rare cases it can lead to malignant hypertension, which can quickly result in death due to impairment of one or more organ systems, including the renal system, the central nervous system, and/or the cardiovascular system.1
Aldosteronism
This condition is caused by tumors of the cortex of the adrenal gland. Such a tumor can increase the secretion of aldosterone, which is responsible for the retention of salt and water, and the excretion of potassium, which results in high blood pressure. This condition is characterized by a number of symptoms including fatigue, muscle spasms, headaches located in the front part of the skull, palpitations, arrhythmias, acute pain in the region of the heart, and heavy breathing. In some patients this condition may lead to heart failure, convulsions and even paralysis. The amount of urine can increase to as many as 4 liters per day.2
Thyrotoxicosis
This is a condition in which excessive amounts of free thyroid hormones, including triiodothyronine and/or thyroxine are released into the bloodstream. This condition can be caused either by hyperthyroidism, a condition in which the thyroid gland is secreting excessive amounts of thyroid hormones, or it can be the result of the inflammation of the thyroid gland (thyroiditis). This condition results in a number of symptoms including high blood pressure. Other common symptoms include weight loss, anxiety, palpitations, arrhythmias, shortness of breath, loss of libido, amenorrhoea, diarrhea, feminization and gynecomastia.
In extreme cases this condition is known as the “thyroid storm”, and is characterized by rapid irregular heartbeat, febrile temperature, diarrhea, vomiting, and mental agitation. Medical treatment should be administered as quickly as possible since this condition results in a large number of mortalities.3
Hyperparathyroidism
Hyperparathyroidism is a condition characterized by the excess secretion of parathyroid hormone. This hormone plays a key role in regulating calcium levels; and too much of it can result in the rise of calcium levels in the bloodstream, while the calcium in the bones is being washed out. This results in osteoporosis (fragile bones), kidney stones (made of calcium), excessive urination, fatigue, abdominal pain, depression, joint pain, nausea and vomiting. Hypertension is also common in patients with hyperparathyroidism, although the reason for it is still debated. People with hyperparathyroidism are found among people with hypertension about ten times more than in general population (1 in 130 vs. 1 in 1,000-2,000). Therefore all patients with hypertension should have a routine serum calcium estimation to exclude the possibility of hyperparathyroidism.4
Medication and supplements
A number of medications can also result in hypertension. For example, corticosteroid medications can result in Cushing’s syndrome, which is characterized by hypertension, central obesity, thinning of the skin and mucous membranes, excess sweating, dilation of capillaries, hirsutism, baldness and hypercholesterolemia. Other medications which may induce high blood pressure are certain types of antidepressants, pain killers, and drugs that are used to prevent the rejection of a transplanted organ. Birth control pills and a number of herbal supplements, such as ephedra, licorice, and ginseng, may also results in elevated blood pressure.5
Conclusion
If you are diagnosed as having hypertension, you shouldn’t disregard it as the “norm” just because everyone in your family, including your dog, has it. Every person with hypertension should ensure that their hypertension is not caused by a tumor or the detrimental effect of a medication. Otherwise the consequences may be dire.
References:
1 Sweeney, Ann T; Griffing, George T (August 2, 2024). "Pheochromocytoma". eMedicine.
Goldman 2011, pp. 1470
2 http://cjasn.asnjournals.org/content/1/5/1039.long
3 http://www.ncbi.nlm.nih.gov/pubmed/16896276
4 Hellstrom J, Birke G, Edvall CA. Hypertension in hyperparathyroidism. Br J Urol. 1958;30(1):13–24. CrossRef
Silverberg SJ, Bilezikian JP. Primary hyperparathyroidism. In: Rosen CJ, editor. Primer on the metabolic bone diseases and disorders of mineral metabolism. 7th ed. Washington, DC: American Society for Bone and Mineral Research; 2008. p. 302–6.
5 Mechanism of glucocorticoid-induced hypertension. Hypertens Res. 1996 Mar;19(1):1-8.
American Heart Association. The Harvard Medical School Family Heath Guide: "Don't Let Decongestants Squeeze Your Heart." Cleveland Clinic.
