A Comprehensive Guide: The Differences, Causes, and Prevention of Primary and Secondary Hypertension

Primary hypertension (PHH): Also known as hypertension, PHH is an independent disease with its own etiology, development, progression, and clinical manifestations. Clinically, it is mainly characterized by elevated arterial blood pressure. The pathogenesis is not yet fully understood; a diagnosis of PHH (hypertension) is made only after ruling out other causes of hypertension. The elevated arterial blood pressure is primarily due to increased resistance in peripheral arterioles, accompanied by varying degrees of increase in blood volume and cardiac output. In later stages, it often leads to serious complications such as hypertensive heart disease, heart failure, renal failure, and cerebral hemorrhage, affecting organs such as the heart, brain, and kidneys.

Treatment for PHH primarily focuses on lowering blood pressure while preventing complications. The leading causes of death in PHH patients are cerebrovascular accidents, cardiovascular accidents, and renal failure. In my country, cerebrovascular accidents are the most common, followed by heart failure and uremia. In Europe and America, heart failure is more common, followed by cerebrovascular accidents and uremia.

Secondary hypertension: Secondary hypertension refers to hypertension secondary to other diseases or causes. Elevated blood pressure is merely a clinical manifestation of these diseases. The clinical manifestations, complications, and consequences of secondary hypertension are similar to those of primary hypertension.

Common causes of secondary hypertension include: ① Kidney diseases, such as acute and chronic glomerulonephritis, pyelonephritis, and renal artery stenosis; ② Large vessel diseases, such as large vessel malformations (congenital aortic coarctation) and Takayasu arteritis; ③ Preeclampsia, which often occurs in late pregnancy and may require termination of pregnancy in severe cases; ④ Endocrine disorders, such as pheochromocytoma and primary aldosteronism; ⑤ Brain diseases, such as brain tumors and brain trauma; ⑥ Drug-induced factors, such as long-term use of oral contraceptives, organ transplantation, and Cushing's syndrome.