What causes hypertensive emergency in patients with no history of chronic essential hypertension (high blood pressure)?

Updated: Feb 22, 2019
  • Author: Matthew R Alexander, MD, PhD; Chief Editor: Eric H Yang, MD  more...
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Answer

Other causes of hypertensive emergencies include the use of recreational drugs, abrupt clonidine withdrawal, post pheochromocytoma removal, and systemic sclerosis, as well as the following:

  • Renal parenchymal disease: chronic pyelonephritis, primary glomerulonephritis, tubulointerstitial nephritis (accounts for 80% of all secondary causes)

  • Systemic disorders with renal involvement: systemic lupus erythematosus, systemic sclerosis, vasculitides

  • Renovascular disease: atherosclerotic disease, fibromuscular dysplasia, polyarteritis nodosa

  • Endocrine disease: pheochromocytoma, Cushing syndrome, primary hyperaldosteronism

  • Drugs: cocaine, [35] amphetamines, cyclosporine, clonidine (withdrawal), phencyclidine, diet pills, oral contraceptive pills

  • Drug interactions: monoamine oxidase inhibitors with tricyclic antidepressants, antihistamines, or tyramine-containing food

  • Central nervous system factors: CNS trauma or spinal cord disorders, such as Guillain-Barré syndrome

  • Coarctation of the aorta

  • Preeclampsia/eclampsia

  • Postoperative hypertension


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