Question

please list 5 conditions that cause secondary hypertension explain the pathogenesis of each.

Answer 1

Ans) 5 conditions that cause secondary hypertension are:

- Renal parenchymal disease and coarctation of the aorta. In adults 65 years and older, atherosclerotic renal artery stenosis, renal failure, and hypothyroidism are common causes.

Pathogenesis of each:

Renal parenchymal disease:

- Low GFR, Juxtaglomerular cells feel low filtrate, stim RAAS system, inc in Na and water retention by aldosterone. Causes inc in BP =Causes edema.
- The more pressure we have in body, the more fluid leaks outside vessels and goes to cells. Low Na also gives us pitting edema.

Coarctation of aorta: The exact mechanism by which aortic coarctation is produced is not clearly understood. The most commonly invoked hypotheses include hemodynamic and ectopic ductal tissue theories. Postnatal spontaneous closure of the ductus arteriosus completes the development of aortic obstruction.

Atherosclerotic renal artery disease: Apart from its role in the pathogenesisof hypertension, renal artery stenosis is also being increasingly recognized as an important cause of chronic renal insufficiency and end-stage renal disease. In older individuals, atherosclerosis is by far the most common etiology of renal artery stenosis.

Chronic kidney disease is initially described as diminished renal reserve or renal insufficiency, which may progress to renal failure (end-stage renal disease). ... Decreased renal function interferes with the kidneys' ability to maintain fluid and electrolyte homeostasis.

Hypothyroidism: The hypothalamus secretes thyrotropin-releasing hormone (TRH) that stimulates the pituitary gland to produce thyroid-stimulating hormone (TSH). Levels of T3 and T4, in turn, exert a negative feedback on the production of TRH and TSH.