Primary vs Secondary hypertension: What’s the difference?

Hypertension or high blood pressure is one of the most undermined health conditions.

In reality, hypertension is a severe cardiovascular problem that can even lead to a heart attack and turn fatal if left unmanaged.

In this condition, the heart works harder to pump blood out to different parts of the body. There are two types of hypertension, and their symptoms differ from each other- primary and secondary.

Also known as essential hypertension, primary hypertension accounts for 95 per cent of the total cases and is diagnosed mostly in adults. Several factors can lead to primary hypertension, but the exact cause is not yet known. As per research, it is thought to be a combination of genetics, lifestyle habits, weight management, smoking habits, sedentary lifestyle and stress level. Since the reason for the development of primary hypertension is unknown, it is essential to get it checked regularly.

Secondary high blood pressure is caused by another medical condition that mostly affects our kidneys, arteries, heart or endocrine system. Other causes include obstruction of the airway during sleep, tumours of the adrenal glands, hormone abnormalities and too much salt or alcohol intake. Secondary hypertension can also be diagnosed during pregnancy. Unlike primary hypertension, secondary hypertension can be easily reversed. It accounts for only 5 to 10 per cent of the total cases of hypertension and is prevalent among those ages 18 to 40.

Both primary and secondary hypertension do not show any symptoms in most cases. Even if the blood pressure level hits the highest mark, it can be hard to identify the signs without the help of a medical expert. In some cases, a person may experience frequent headaches, fatigue, vision problem and breathlessness. But there may be some indications to know you have secondary hypertension.

• If your blood pressure doesn’t respond to medication it responded to previously
• Your blood pressure is extremely high
• No family history of high blood pressure
• Not overweight or obese
• Sudden onset of hypertension before age 30 or after 55

Apart from these two basic types of hypertension, there are some subtypes that fit within the categories of primary or secondary hypertension. They may include:

Resistant hypertension: This type of hypertension is difficult to control and may require multiple medications. High blood pressure is called resistance when the blood pressure stays above your treatment level.

Malignant hypertension: Being diagnosed with this kind of hypertension is generally an emergency. The term is used to describe high blood pressure that can damage your organs.

Isolated hypertension: This type of hypertension is more common among older adults. In this, the systolic blood pressure is above 140 mm Hg and diastolic blood pressure is under 90 mm Hg.

The blood pressure monitoring machine reflects two numbers -systolic (the top number) and diastolic (the bottom number). The top number is for the pressure of the blood when the heart is contracting and the bottom number is for the pressure when the heart muscles relax. The blood pressure level is measured in millimetres of mercury (mm Hg) and is categorised like:

Low blood pressure: Systolic lower than 90 mm Hg or diastolic less than 60 mm Hg.

Normal: Systolic less than 120 and diastolic less than 80 mm Hg.

Elevated blood pressure: Systolic above 120 mm Hg or diastolic above 80 mm Hg.