The Hidden Truth About Secondary Hypertension: What Every Senior Needs to Know

If you’re over 60 and your blood pressure remains high despite your best efforts, it may not be due to aging alone. Nearly 1 in 5 cases of hypertension have an underlying cause, and most remain undiagnosed. This article explores the signs, causes, and treatment options of secondary hypertension, helping you become your own best health advocate.

Understanding Secondary Hypertension: Causes, Symptoms, and Solutions for Older Adults

For years, I believed that my rising blood pressure was just a natural part of getting older. Like many seniors, I followed my doctor’s advice, took my medications religiously, and watched what I ate. Yet, my numbers stayed stubbornly high. It wasn’t until I passed out in my garage that I realized something deeper might be going on.

What is Secondary Hypertension?

Unlike primary hypertension—an often unexplained, lifelong condition—secondary hypertension has a specific, identifiable cause. It accounts for up to 20% of all hypertension cases, but is often overlooked, especially in older adults. If your blood pressure is not responding well to medication or if it fluctuates wildly, you may be dealing with this hidden issue.

Common Causes of Secondary Hypertension

Here are some of the most common culprits that could be hiding behind your undiagnosed hypertension:

1. Obstructive Sleep Apnea

Interrupted breathing during sleep can lead to oxygen deprivation, causing your body to release stress hormones that elevate blood pressure. Up to 50% of those with obstructive sleep apnea also have hypertension.

2. Primary Aldosteronism

This adrenal gland disorder causes an overproduction of aldosterone, leading your body to retain sodium and lose potassium, two key drivers of high blood pressure. It’s a leading cause of resistant hypertension.

3. Renal Artery Stenosis

Narrowed arteries to the kidneys reduce blood flow, prompting your body to raise your blood pressure to compensate. It’s a common cause of hypertension in older adults.

4. Kidney Disease and Hypertension

Chronic kidney disease impairs your kidneys’ ability to filter blood and regulate blood pressure. If your labs show decreased kidney function, it’s a red flag.

5. Thyroid Disorders and Hormonal Imbalance

Both overactive and underactive thyroids can contribute to hormonal imbalance and blood pressure spikes. Thyroid disorders often go unnoticed in seniors, but can be key to diagnosing secondary hypertension.

6. Drug-Induced Hypertension

Many over-the-counter and prescription drugs—including NSAIDs, decongestants, antidepressants, and certain herbal supplements—can raise blood pressure. This is known as drug-induced hypertension and is often missed.

Symptoms to Watch For

Secondary hypertension can mimic primary hypertension, but there are key differences:

• Blood pressure that remains high despite multiple hypertension medications
• Sudden spikes or fluctuations in readings
• Fatigue, chest fluttering, dizziness
• Cold hands and feet
• Frequent headaches

Diagnosing Secondary Hypertension

If you suspect something is being missed, here’s how to approach your doctor:

1. Prepare Your Symptoms: Keep a log of your readings, diet, medications, and symptoms.
2. Request Specific Tests: These may include kidney function tests, adrenal hormone levels, thyroid panels, and imaging procedures such as a CT scan.
3. Discuss Medication Side Effects: Don’t overlook your current prescriptions.
4. Consider a Sleep Study: If you snore or wake up tired, test for sleep apnea and hypertension.

Treatment for Secondary Hypertension

The key is treating the root cause, not just masking symptoms. Here’s how:

• Targeted Medications: For example, aldosterone blockers for primary aldosteronism.
• Lifestyle Changes: Reducing sodium, exercising, and managing stress.
• Surgical Interventions: In cases like renal artery stenosis, surgery may restore blood flow.

You’re Not Alone

Hypertension is common in seniors, but that doesn’t mean it should go unchecked. By understanding the causes of high blood pressure beyond the usual suspects, you give yourself the power to demand better care and better outcomes.

💬 Have you been told your high blood pressure is just part of aging? Drop a comment below. Your story might help someone else find answers they’ve been missing.

🧠 Stay tuned for our downloadable checklist for your next doctor visit—coming soon!