I am searching for information on causes of high blood pressure — information that goes beyond the standard. I am a relatively healthy, 44-year-old male (6’1″, 225 pounds). I am currently taking three separate medicines, yet my blood pressure remains higher than it should.
I’m going to have an MRI scan for a growth on my adrenal glands, which may cause this continual high blood pressure, but I cannot find any literature on the relationship between adrenal glands and high blood pressure. Any suggestions of reading material and sources?
The causes of hypertension are roughly divided into essential hypertension, where no cause for the condition can be found, and secondary hypertension, which by definition has a cause. Essential hypertension accounts for well over 90 percent of all cases. There are quite a few causes of secondary hypertension, but most are related to either drug use, alcohol, oral contraceptives, estrogens, excessive steroid (cortisone) or thyroid-type drugs, amphetamines; or excessive secretion of hormones from the adrenal glands; or various types of kidney disease.
Persons with a gradual onset of hypertension in their 40’s or 50’s, who have a family history of hypertension, and whose hypertension is not difficult to control, usually have essential hypertension, and do not require more extensive workup. Treatment should include losing weight if you are heavy. Even a 10-pound weight loss may help in controlling your pressure.
In someone who does not fit this profile, further investigation is in order. Your doctor is evidently thinking about an adrenal tumor or enlargement as the cause of your hypertension. An MRI will also detect, rather expensively, several forms of kidney disease.
The adrenal glands secrete three types of hormone which can cause hypertension. Each may come from a tumor or overgrowth of the gland that is producing excessive amounts of the hormone. These tumors are usually benign, but dangerous because of the excessive hormone production. Cortisone and aldosterone, both secreted by the adrenal cortex, can cause hypertension; and adrenalin, secreted by the adrenal medulla can as well. The tumor that secretes adrenalin is called a pheochromocytoma. The hypertension caused by this hormone is often sporadic, with episodes of palpitations, sweating, and high blood pressure, alternating with periods when the blood pressure is normal.
If you indeed have a form of secondary hypertension, my bet would be that it stems from a kidney problem. Polycystic disease of the kidneys, various kinds of nephritis, and interference with the blood supply to one or both kidneys can all cause a severe, difficult to treat hypertension. A sonogram of the kidneys with urine and blood tests would find most of these problems. Of course your doctor may have other reasons, such as your appearance on physical exam, or blood tests, to think of an adrenal problem, in which case an MRI would be indicated.