Hypertension, Secondary

(also symptomatic hypertension), a pathological state arising as a syndrome or symptom of a disease and characterized by an increase in arterial pressure. Often it is precisely secondary hypertension that determines the severity of the fundamental disease.

The most frequent causes of secondary hypertension are kidney diseases, including renal hypertension with diffuse glomerulonephritis, nephropathy during pregnancy, pyelonephritis, and anomalies in the development of the uro-poietic system. Secondary hypertension usually accompanies congenital or acquired diseases of the main renal arteries and the aorta, including coarctation and pulseless disease caused by panarteritis of the aorta and its branches. It is often the principal clinical manifestation of such endocrine diseases as pheo-chromocytoma, Itsenko-Cushing’s disease, and primary hyper-aldosteronism or of such diseases of the central nervous system as craniocerebral trauma.

The selection and effectiveness of a treatment method, including surgical treatment, are determined by the characteristics

Table 1. Classification of metal ions
Analytical group	Group composition	Group reagent	Solubility of salts
I	K⁺, Na⁺, NH4⁺, and others	None	Soluble
II	Ba²⁺, Sr²⁺, Ca²⁺, and others	(NH₄)₂CO₃	Sulfides are soluble;carbonates are practically insoluble in water
III	Al3⁺, Cr³⁺, Fe²⁺, Fe³⁺, Zn²⁺, Co²⁺, and others	(NH₄)₂S	Sulfides (or hydroxides) are soluble in dilute acids
IV	first subgroup: Cu²⁺, Cd²⁺, Bi³⁺, Pb²⁺, and others second subgroup: As(III), As(V), Sb(III), Sn(II), and others	H₂S(in the presence of HCl) H₂S(in the presence of HCl)	Sulfides insoluble in (NH₄)₂S_n and dilute acids Sulfides insoluble in dilute acids, soluble in(NH₄)₂S_n
V	Ag⁺, [Hg₂]²⁺, Cu(II), and others	HCl	Chlorides slightly soluble in water and dilute acids

of the basic disease and the mechanism of the pathogenesis of secondary hypertension. With many diseases, secondary hypertension develops as a protective (compensatory) reaction directed toward the preservation of an adequate blood supply to vitally important organs; in such cases, arterial pressure is not lowered to its normal level. Thus, the problem of whether or not to lower arterial pressure with pulseless disease or atherosclerosis of the aorta is resolved cautiously in order not to produce ischemia of the brain and other organs.

REFERENCE

Ratner, N. A. Arterial’nye giperlonii. Moscow, 1974.

F. M. PALEEVA