Secondary hypertension and continuum of rising cases

Miloš Mijalković Orcid logo ,
Miloš Mijalković
Saddam Shawamri Orcid logo ,
Saddam Shawamri
Dalila Sacic Orcid logo ,
Dalila Sacic
Slavica Pajovic Orcid logo
Slavica Pajovic

Editor: Bojana Kisic

Published: 27.04.2026.

Volume 54, Issue 1 (2024)

pp. 22-31;

https://doi.org/10.70949/pramed202601000M

Abstract

Arterial hypertension is well-known strong risk factor that can lead to the development of coronary artery disease, heart attacks, heart failure, stroke, and other heart-related issues. Arterial hypertension has increased exponentially in the last few decades in adult men and women. Traditionally arterial hypertension is classified as primary, when no specific cause has been identified and is usually associated with multiple genetic polymorphisms and various environmental factor interactions, and secondary when there are conditions with biological plausibility to cause hypertension. Traditional data in medical textbooks indicate that in 90-95% of cases, arterial hypertension is primary, while only a small percentage of cases have secondary hypertension. European guidelines for elevated blood pressure and hypertension from 2024 indicate a higher prevalence of secondary hypertension, ranging from 10-35% of cases. Secondary hypertension is still not fully understood and often remains undiagnosed. Identifying the underlying cause of secondary hypertension is crucial, as treating the root condition can significantly reduce the risk of heart disease, stroke, and improve overall quality of life. Obesity is a major global health problem and the prevalence of obesity is constantly increasing and simultaneously leads to an increase in the prevalence of both primary and secondary arterial hypertension. Some forms of secondary hypertension cause more severe cardiac damage than primary hypertension and are associated with a higher cardiovascular risk. Secondary hypertension is more often resistant hypertension, which means that it is difficult to achieve target blood pressure values. It is important to timely conduct appropriate examinations and begin treatment promptly.

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