High Blood Pressure (cont.)
Adrenal gland tumors
Two rare types of tumors of the adrenal glands are less common, secondary causes of hypertension. The adrenal glands sit right on top of the kidneys. Both of these tumors produce excessive amounts of adrenal hormones that cause high blood pressure. These tumors can be diagnosed from blood tests, urine tests, and imaging studies of the adrenal glands. Surgery is often required to remove these tumors or the adrenal gland (adrenalectomy), which usually relieves the hypertension.
One of the types of adrenal tumors causes a condition that is called primary hyperaldosteronism because the tumor produces excessive amounts of the hormone aldosterone. In addition to the hypertension, this condition causes the loss of excessive amounts of potassium from the body into the urine, which results in a low level of potassium in the blood. Hyperaldosteronism is generally first suspected in a person with hypertension when low potassium is also found in the blood. (Also, certain rare genetic disorders affecting the hormones of the adrenal gland can cause secondary hypertension.)
The other type of adrenal tumor that can cause secondary
hypertension is called a pheochromocytoma. This tumor produces excessive
catecholamines, which include several adrenaline-related hormones. The diagnosis
of a pheochromocytoma is suspected in individuals who have sudden and recurrent
episodes of hypertension that are associated with flushing of the skin, rapid heart beating
(palpitations), and sweating, in addition to the symptoms associated with high
blood pressure.
Coarctation of the aorta
Coarctation of the aorta is a rare hereditary disorder that is one of the most
common causes of hypertension in children. This condition is characterized by a
narrowing of a segment of the aorta, the main large artery coming from the
heart. The aorta delivers blood to the arteries that supply all of the body's
organs, including the kidneys.
The narrowed segment (coarctation) of the aorta generally occurs above the renal
arteries, which causes a reduced blood flow to the kidneys. This lack of blood
to the kidneys prompts the renin-angiotensin-aldosterone hormonal system to
elevate the blood pressure. Treatment of the coarctation is usually the surgical
correction of the narrowed segment of the aorta. Sometimes, balloon angioplasty
(as described above for renal artery stenosis) can be used to widen (dilate) the
coarctation of the aorta.
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