Can hypertension be cured? Absolutely! When elevated blood pressure is a symptom of an underlying condition, curing the primary disease often resolves the hypertension. Dr. Guo Ying, Associate Chief Physician at Sun Yat-sen Memorial Hospital, Sun Yat-sen University, notes that curable secondary hypertension is not rare but frequently misdiagnosed or overlooked. Suspect cases warrant special attention.
Abnormal Weight Gain in Hypertension Patients
Mr. Li had been living with hypertension for three years. Since his diagnosis, his abdomen had grown progressively larger, his face increasingly rounder, and his facial skin flushed. Purple streaks appeared on the inner thighs and waist, occasionally accompanied by bruising.
As his weight continued to climb, Mr. Li noticed his weight gain felt "off": his neck and shoulders grew thicker while his limbs became increasingly thin. This was accompanied by leg weakness and difficulty walking. More troublingly, his blood pressure kept rising despite taking several antihypertensive medications, with systolic readings exceeding 160 mmHg.Recognizing the severity of his condition, Mr. Li sought treatment at the Endocrinology Department of Sun Yat-sen Memorial Hospital, Sun Yat-sen University, hoping to control his blood pressure and identify the cause of his persistent weight gain.
After a comprehensive examination, doctors discovered significantly elevated cortisol levels and a small pituitary adenoma in Mr. Li. He was diagnosed with Cushing's syndrome. Following surgical removal of the pituitary tumor, his blood pressure returned to normal, and his other symptoms improved.
Hypertension That Can Be Cured
Dr. Zhou Jing, attending physician at Sun Yat-sen Memorial Hospital's Endocrinology Department, explained that Mr. Li's hypertension was secondary hypertension. Typically, treating the underlying condition can lower blood pressure.
Most people perceive hypertension as a chronic condition requiring lifelong medication, yet secondary hypertension is often overlooked. This type accounts for approximately 5% of hypertension cases. Beyond the risks inherent to high blood pressure itself, secondary hypertension can cause severe cardiovascular and cerebrovascular damage, posing greater hazards than primary hypertension. Early identification and treatment are crucial for achieving a cure.
Guo Ying emphasized that screening for underlying causes enables targeted treatment for secondary hypertension patients. If the root cause is addressed before severe damage occurs in target organs (heart, brain, kidneys, etc.), hypertension can be effectively cured.
However, diagnosing and treating secondary hypertension is not as straightforward as one might imagine. Due to a lack of relevant knowledge, low public awareness, and subtle early clinical manifestations, secondary hypertension is highly prone to being missed or misdiagnosed. Therefore, newly diagnosed hypertension patients should undergo screening for common secondary causes.Refractory hypertension should prompt consideration of secondary hypertension. Patients in this category may seek consultation with endocrinology or hypertension specialists.
What are the characteristics of secondary hypertension?
Which types of hypertension may be secondary?
(1) Patients under 30 years old with moderately to severely elevated blood pressure (systolic >160 mmHg or diastolic >100 mmHg);
(2) Elderly patients with previously normal blood pressure or stable control under regular antihypertensive medication who suddenly develop elevated blood pressure or experience diminished response to existing antihypertensive drugs, exhibiting significant blood pressure fluctuations and poor response to drug therapy;
(3) Refractory hypertension (blood pressure remains uncontrolled despite using three antihypertensive drugs);
(4) Accelerated or malignant hypertension, characterized by a brief history but severe damage to target organs (heart, brain, kidneys), rapid progression, and difficult-to-control disease;
(5) Specific symptoms/signs: muscle weakness, periodic limb paralysis; marked heat intolerance, sweating, weight loss, palpitations; snoring with recurrent sleep apnea or gasping; episodic headaches, pallor, sweating, blurred vision, chest tightness, palpitations;Central obesity, Cushingoid appearance, menstrual irregularities, hirsutism, and increased fracture risk;
(6) Early-onset coronary heart disease, history of stroke, or family history thereof;
(7) Hypertensive patients presenting unexplained renal dysfunction, abnormal blood counts, electrolyte imbalances, bilateral renal size asymmetry, or incidental adrenal masses during physical or clinical examinations.