High blood pressure or hypertension is commonly detected during routine check up. This is more common as we age. In most people with hypertension, no underlying reason for elevated blood pressure is found. People are just put on blood pressure lowering medications or antihypertensives.

However, when high blood pressure is found at a younger age or if blood pressure is not controlled with the usual blood pressure lowering medications, investigations need to be done.

What are the reasons for high blood pressure (Hypertension)?

When no cause for high blood pressure is found it is called primary or idiopathic hypertension. In some people reducing weight, reducing salt intake, improving sleep and reducing alcohol intake can help reduce blood pressure.

Excessive salt intake and liquorice is known to increase blood pressure.

There are several hormonal causes for hypertension, which include:

• Conn’s syndrome (primary hyperaldosteronism)
• Phaeochromocytoma
• Cushing’s syndrome
• Hyperparathyroidism

Sometimes the problem could be in the heart. Narrowing of aortic valve or aortic stenosis, cardiomyopathy or co-arctation of aorta can lead to hypertension.

Medications causing high blood pressure include:

• Steroids (hydrocortisone, prednisolone)
• Oral contraceptives
• Cyclosporine
• Erythorpoetin
• Some nasal decongestants

Other conditions which can lead to high blood pressure include:

• Kidney disease
• Sleep apnoea
• Renal artery stenosis

What can happen if Hypertension is not properly treated?

If blood pressure is not well controlled, there is a risk of the following conditions:

• Chronic kidney disease
• Kidney failure
• Heart attack
• Heart failure
• Atrial fibrillation
• Stroke

What investigations are done for high blood pressure?

Investigations for high blood pressure will depend on several factors and the endocrinologist will arrange tests based on the history and clinical examination.

Several blood tests, 24 hour urine test to check for hormone abnormalities are done. This again depends on the symptoms experienced.

This includes blood tests, hormone tests, 24 blood pressure monitoring, echocardiogram and some scans if appropriate.

What is the treatment for high and uncontrolled Blood pressure?

Once the underlying reason for high blood pressure is detected, treatment will be directed to the underlying cause. In addition blood pressure lowering medications will be changed and newer medication may be added.

If you are unwell (severe headache, visual disturbance) with high blood pressure, you should go to the nearest A&E.

Dr Chinnadorai Rajeswaran is a consultant Physician specialising in Endocrinology, Diabetes and Obesity. As a private endocrinologist he  has private endocrine, diabetes and weight loss clinics in Harley Street, London, Chennai (India), Claremont Hospital, Sheffield, Nuffield Hospital, Leeds and Simplyweight, Bradford.

He has face to face consultations with people from Barnsley, Rotherham, Chesterfield, Doncaster, Wakefield, Huddersfield, Bradford, Harrogate, Leeds, Sheffield, London and Chennai (India). He also offers video consultations.