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Secondary hypertension / Pathology / USMLE Step 1

A number of common and uncommon medical conditions may increase blood pressure and lead to secondary hypertension. In many cases, these causes may coexist with risk factors for primary hypertension and are significant barriers to achieving adequate blood pressure control. (See "Evaluation of secondary hypertension" and "Definition, risk factors, and evaluation of resistant hypertension", section on 'Secondary causes of hypertension'.)

Major causes of secondary hypertension include:

●Prescription or over-the-counter medications

•Oral contraceptives, particularly those containing higher doses of estrogen

•Nonsteroidal antiinflammatory agents (NSAIDs), particularly chronic use

•Antidepressants, including tricyclic antidepressants, selective serotonin reuptake inhibitors, and monoamine oxidase inhibitors

•Corticosteroids, including both glucocorticoids and mineralocorticoids

•Decongestants, such as phenylephrine and pseudoephedrine

•Some weight-loss medications

•Sodium-containing antacids

•Erythropoietin

•Cyclosporine or tacrolimus

•Stimulants, including methylphenidate and amphetamines

•Atypical antipsychotics, including clozapine and olanzapine

•Angiogenesis inhibitors, such as bevacizumab

•Tyrosine kinase inhibitors, such as sunitinib and sorafenib

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