A sudden rise in blood pressure needs investigation

High blood pressure with a sudden onset, rapid deterioration, or occurring in someone under 40 years old may have an underlying cause. In the latest edition of Australian Prescriber, Drs Michael Page, Ranita Siru and co-authors from Western Diagnostic Pathology in Perth look at the conditions that can trigger high blood pressure, and review the tests that should be done.

Underlying conditions may cause about 1 in 10 cases of high blood pressure. They include kidney disease and problems with the adrenal glands. Medicines, caffeine, nicotine and illicit drugs like cocaine and amphetamines may also increase blood pressure.

“Your doctor may do some further investigations of possible causes for high blood pressure if you are under 40 years old, if it has suddenly got worse or if it isn’t being helped by blood pressure-lowering medicines,” says Dr Page.

“Also, investigations may be needed if your family has had a history of early-onset high blood pressure or stroke,” he says.

The Australian Prescriber article goes into the details of the clinical clues that could indicate a problem that needs further investigation. Some of these clues can be detected in blood tests. Others may be symptoms like easy bruising, muscle wasting or palpitations or headaches.

The article discusses the tests needed to work out the underlying cause. This is important because the cause may be treatable.

“Identifying an underlying cause allows us to reduce the high blood pressure, and the associated risk to your heart, beyond what we can do with blood pressure-lowering medicines alone,” says Dr Page.

Read the article in Australian Prescriber.