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Primary Vs Secondary Hypertension: Doctor Explains The Difference

Hypertension is when the blood pressure is higher than 120/80 mmHg. Based on the cause it can be primary and secondary hypertension.

Varun Verma
Written by: Varun VermaUpdated at: May 25, 2023 16:02 IST
Primary Vs Secondary Hypertension: Doctor Explains The Difference

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Blood pressure is one of the most critical indicators of our overall health and well-being. When your blood pressure is too high, it can lead to severe health complications, such as heart disease, stroke, and kidney failure. But do you know that there are many types of hypertension? To know more about them, we reached out to Dr Sashi Kiran A, Consultant Nephrologist, Yashoda Hospitals, Hyderabad.

Types of Hypertension

"Depending on the severity of blood pressure and the age, hypertension is classified as elevated blood pressure (also known as prehypertension), stage I hypertension, and stage II hypertension," said Dr Kiran. 

He added that hypertension is also classified as primary hypertension if there is no identifiable cause and secondary hypertension if an identifiable cause is found.


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Cause of Hypertension

Optimal blood pressure is necessary for the normal function of every organ. "This pressure is maintained in the body by a complex interplay between the sympathetic nervous system (a nerve network that aids your body's fight-or-flight reaction), the kidneys (renin-angiotensin-aldosterone system), and plasma volume," said the doctor.

Causes of Primary Hypertension

Dr Kiran said, "The cause for the development of hypertension is poorly understood, but most likely due to a cumulative effect of numerous environmental and genetic factors, which affect the kidney and heart."


He added that though the exact cause of primary hypertension is unclear, but several possible risk factors are associated with its development. The most notable being are as follows:

  • Ageing
  • Family history: Hypertension often runs in the family, and its occurrence is doubled if a parent is hypertensive.
  • Obesity
  • Salt intake in diets containing above three grams per day
  • Reduced kidney nephron is also known to cause hypertension.
  • Excessive alcohol consumption
  • Sedentary lifestyle
  • Insufficient sleep
  • Low socioeconomic status 

Causes of Secondary Hypertension

Dr Kiran said, "Diseases involving the kidneys, thyroid gland, adrenal gland, blood vessels, obstructive sleep apnoea, and medications can lead to secondary hypertension." 

"The identification of a secondary cause is of paramount importance as appropriate treatment of the cause would mitigate hypertension," added the doctor.

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Things to Keep In Mind

"Most often hypertension is identified through routine screening. People without any risk factors and above the age of 40 years need to get screened for hypertension at least once a year," said Dr Kiran. He added that screening should be more frequent and at younger ages in patients with the risk factors mentioned above.


Dr Kiran said, "Once a diagnosis of hypertension is made, effort should be made to identify secondary causes. Once secondary causes are ruled out, the next step is to assess the end organ function. These would include assessing the function of the kidneys, heart, brain and eyes."

"Treatment should start with a modification of lifestyle. This would include modifying the diet, reducing salt and alcohol consumption, and increasing physical activity to reduce obesity," said the doctor. 

"Next comes the use of appropriate medication for the control of blood pressure. The choice of medications depends upon the patient’s profile and may be unique to that person," he added.

[Disclaimer: The information in this article is provided by a registered medical practitioner. However, we recommend you consult your healthcare provider for accurate diagnosis and treatment.]