Hidden High Blood Pressure Causes [Secondary Hypertension causes] - 2026

first I'm going to tell you something that you know and then I'm going to tell you something that you don't know and then we're going to go into quite a bit of detail about what you currently probably don't know and also uh hint your doctor may not know about this either or may have forgotten it secondary hypertension so you already know that millions of people around the world have a diagnosis of hypertension high blood pressure what you may not know is that up to 20% of these people have something called secondary hypertension this is far

too common to be so greatly underdiagnosed now what's the difference between primary hypertension and secondary hypertension by far the most common diagnosis is primary hypertension or essential hypertension now what the average doctor means by this is that oh you have high blood pressure but we don't really know why you have high blood pressure what I found in my 22 years of clinical experience and reading tons of research papers is that primary hypertension essential hypertension is almost invariably caused by hyperinsulinemia and that's why a ketogenic diet or a carnivore diet which lowers your insulin back to

low normal levels is so good at reversing primary or essential hypertension now secondary hypertension is different there's actually a medical cause for secondary hypertension that your doctor should be looking for because remember we said one out of five people with high blood pressure have secondary hypertension this could be an endocrine problem with your hormones this could be a kidney problem this could be a thyroid problem this could be an adrenal problem so I'm going to go through this because the problem here is that many many Primary Care Health Care Providers either didn't learn about all

the causes of secondary hypertension and what tests you would order to diagnose them or they're so busy with essential hypertension because it's 80% of the cases that they see and then often they assume that the the other 20% of secondary hypertension is also essential hypertension doctors are taught in medical school that when you hear hoof beats you should think of horses not zebras and the meaning behind this is that you should always considered the most common cause of a disease or a condition and so when they hear hoof beats AKA your high blood your blood

pressure is high multiple times when you're checking it properly at home then you probably have 80% of the time it's primary or essential hypertension and they're right to think that but if your blood pressure is weird in some way and I'm going to get into the ways that secondary hypertension is weird compared to primary or essential hypertension later in this video then they should immediately start an investigation to look for causes of secondary hypertension and the things that they look for should be based on your age on your condition how high your blood pressure is

how your blood pressure responds to the medications that they're trying to lowerer it with I'm Dr Ken Barry a family physician let's talk about this hidden cause of high blood pressure that your doctor may not know about now let's first cover the signs and symptoms that your high blood pressure may be have a secondary cause the first starts on the physical exam which your doctor should do a thorough physical exam on you at least the very first visit and then typically once a year you should complete another thorough physical exam where they actually put their

hands on you and examine your body and listen to you with a stethoscope so if they detect that your arm tole systolic blood pressure is uh more than 20 points different that can be a sign of secondary hypertension if you have delayed or absent femoral pulses those are the pulses in your groin then that could be a sign of secondary hypertension if you have a heart murmur when's the last time your doctor listened to your heartbeat if you have an abdominal murmur called a brewery over the kidney arteries this can be a sign of second

secondary hypertension if you have an any increase in your creatinine level which is a kidney lab or any sign of kidney malfunction or dysfunction then that increases your risk that your hypertension is actually secondary hypertension now the reason we care so much about diagnosing teasing out secondary hypertension from primary hypertension is for two reasons one often can actually fix the underlying root cause of secondary hypertension rather quickly with a procedure or with a specific medication and then second if you have secondary hypertension that often puts you at risk of having another underlying undiagnosed medical condition

that may be causing your secondary hypertension any indication of kidney disease or kidney damage if you start an Ace inhibitor or an ARB these are blood pressure medications and you have a weird response to it or your your kidneys suddenly showing the blood work that you're these are damaging your kidneys that could be a sign of secondary hypertension if you you have a fast heartbeat or a slow heartbeat if you're feel always cold or you feel always hot if you have chronic constipation or chronic diarrhea if you have an irregular heavier absent menstrual period all

those things can be a sign that you may have secondary hypertension and should be investigated thoroughly if you have uh ever had a potassium measurement in your blood that's even one tenth of one point low that could be a sign that you have an underlying secondary cause of hypertension if you have apneic events during sleep if you stop breathing while you're asleep your bed partner says dude you stop breathing all the time if you have daytime sleepiness if you snore so loud that it wakes the neighbors up these can be signs of a cause of

secondary hypertension if you have facial flushing if you have headaches if you have blood pressures that are some days normal and some days super high if when you stand up your blood pressure goes very low if you have heart palpitations very frequently if you just have episodes where you sweat for no reason or if you have episodes where you either pass out or you almost pass out and those are repetitive those can be indications of secondary hypertension also if you have a a hump of fat on your neck known as a buffalo hump if you

have you're very obese right in the middle of your body but your arms and legs are kind of skinny if you have a very round face versus a nor more normal shaped face or if you have stretch marks for really no reason and and lots of very noticeable stretch marks these can all be signs of secondary hypertension now keep in mind that one out of every five people watching this video with high blood pressure has a secondary cause of that that could be corrected that needs to be discovered investigated diagnosed and treated and so this

could be you and so if you have any of the symptoms or signs I just went over if you have blood pressure that's still still high even though you're taking two or three or four different blood pressure medications you might have secondary hypertension and you need to have that investigated now to be very honest with you many Primary Care Health Care Providers are not knowledgeable enough to know which tests to check and so you might uh initially want to get this worked up with your primary care provider but if they don't find anything and you

still Harbor a a suspicion that you're blood pressure is somehow weird it's not acting right then you should probably ask for a referral to a Cardiologist who specializes in hypertension or even an endocrinologist so that you can be fully worked up and make sure that you don't have secondary hypertension when you've just been diagnosed with high blood pressure now remember earlier I said that it depends on your age as to which cause of secondary hypertension you might have in kids from 0 to 12 years years of age we're going to be really looking at the

kidneys looking for an inborn uh renal defect or looking for coarctation of the aorta in kids 12 to 18 years of age we're going to be looking again at the kidney very closely and at the aorta very closely and young adults from 19 to 39 years of age we're going to be looking at the thyroid we're going to be looking at fibromuscular dysplasia we're going to be looking again very carefully at the kidney to look at the the renal arteries and the kidneys themselves to make sure there's not a secondary cause of high blood pressure

hiding in the kidneys for adults from age 40 to 64 we're going to be looking at the adrenal glands aldosteronism is a very common cause thyroid dysfunction again in this age group obstructive sleep apnea yeah that can cause secondary hypertension foch chromosoma is an adrenal condition that can also lead to very severe secondary hypertension now an adult 65 years and of age and older we're going to be looking at atherosclerotic kidney disease so really looking at the renal arteries to see if there's a plaque buildup that's blocking the blood flow and that can cause severe

hypertension we're going to be looking for signs of renal failure which can also cause secondary hypertension as well and then hypothyroidism in this group now these categories based on the different age ranges are not set in stone if you have a a 10-year-old child who's severely severely obese and has high blood pressure they may have sleep apnea so just because you don't fall into one of these age categories this this warning goes for patients and for doctors just because you don't fall in that age category doesn't mean that you definitely cannot have that cause of

secondary hypertension probably the most often missed cause of secondary hypertension is primary aloster onism this is an adrenal hormone defect up to 10 to 15% of people with hypertension high blood pressure can have this and it's just hasn't been caught by their doctor another quite common cause is the renal perinal disease which is uh can can be glome nephritis polycystic kidney disease and and other kidney conditions as well this is probably 2 to 5% of people with high blood pressure they have kidney disease and their doctor just hasn't disced Ed it another is renovascular hypertension

this is probably 1 to 2% of cases of of hypertension can be caused by the narrowing narrowing of the artery supplying the kidney with arterial blood like renal artery stenosis and so it can be due to atherosclerosis but it can also be due to fibromuscular dysplasia and so this has to be teased out because if you have any of these secondary causes of hypertension first of all you're obviously at increased risk of heart attack and stroke because you have high blood pressure but secondly you also are not going to respond to the blood pressure medications

because you don't have just essential hypertension which is going to respond is 80% of cases and it's going to respond to a very low carbohydrate diet because it's essentially uh hyperinsulinemia and so that's why keto and carnivore work so great for for primary or essential hypertension but if you and and so so if any of you guys have adopted a proper human diet low carb keto ketovore carnivore and yet your blood pressure is still much much higher than it should be it has not returned to normal then that absolutely is a sign that you probably

have a secondary cause of hypertension and you should talk to your doctor about this if they feel comfortable working it up fine let them begin but you may need to wind up in a cardiologist office or an endocrinologist office who specializes in high blood pressure now here's another thing that you probably didn't know there's a pretty long list of medications that can cause secondary hypertension so this is a medication that your doctors prescribed for you for some other condition and one of the side effects of this medication is that it has raised your blood pressure

to the point where you now are classify as having hypertension uh any of the cyc oxygenase uh two inhibitors like celibre or celox and this is called different names in different countries that can cause H hypertension in some people and that's a secondary cause any of the nonsteroidal anti-inflammatory drugs uh ibuprofen neoen Al ibuprofen Advil Motrin korac tool any of the anti-inflammatories that you might take for a headache many of these medicines are over the counter also there's a large list of them that better prescription depending on which country you live in and so many

doctors hand these out like candy almost for free like oh you've got a headache here's a year worth of ibuprofen or generic celra or some other anti-inflammatory and these can act absolutely cause secondary hypertension another of the overthe counter more herbal things are a fedra jing and mahong these can cause high blood pressure in some people any amphetamin including the prescription amphetamines right like Aderall can cause eye blood pressure but then also any illegal amphetamine or cocaine any of the illicit drugs can cause secondary hypertension cyclosporin cimus and tacrolimus these are very uncommon medications but

if you if you're taking if you're taking one you real you recognize the name just then bupar used for depression and mental health issues can absolutely cause secondary hypertension integrity ol cleril lithium any of the monoamine oxidase Inhibitors used for mental health problems can cause secondary hypertension any of the ssris like Prozac paxel Zoloft Lexapro axer in some people can cause secondary hypertension any of the serotonin nor epinephrine reuptake Inhibitors again used for mental health issues can cause secondary hypertension and then also any of the tricyclic antidepressants can cause secondary hyper attention as well I'm

not going to list all these but if you're taking an anti-depressant or an anti-inflammatory you need to ask your doctor is it possible that this is contributing to my high blood pressure for the women if you are taking an estrogen pill or an estrogen progesterone combo these are notorious for causing higher blood pressure than you would have if you weren't taking them in many women this pushes you over the cut off for having hypertension and then you wind up taking a blood pressure medication or two or three but you really have a high blood pressure

caused by your birth control pill or your menopause pill any of the steroids whether it's prednizone solumedrol methyl pricone any of the steroids are going to have the potential to cause secondary hypertension and then also any over-the-counter or prescription anti-histamine or decongestant can cause secondary hypertension so if you're taking any of these things every single day for months and months and months they could be contributing to your hypertension although most people don't consider them to be drugs also keep in mind that chronic abuse of nicotine or alcohol can also lead to secondary hypertension now I've

included some research down in the show notes if you want to read further into this or maybe print that research out and take to your doctor so they'll know which test to actually order if you suspect that you have secondary hypertension if you have any kind of hypertension I would highly encourage you to adopt a proper human diet if you don't currently know what that is or what that means you can get my free guide book down in the show notes a proper human dieet guide book that tells you how to eat and enjoy all

the benefits of a very low carbohydrate nutrient-dense ancestrally appropriate proper human diet I have several other videos on this channel about high blood pressure and how you can improve it uh I'm going to put a link to my high blood pressure playlist down in the show notes but then also at the end of this video here in here some videos will pop up about hypertension if you want to learn even more hope this video helps this is Dr Barry I'll see you next time first I'm going to tell you something that you know and then

I'm going to tell you something that you don't know and then we're going to go into quite a bit of detail about what you currently probably don't know and also uh hint your doctor may not know about this either or may have forgotten it secondary hypertension so you already know that millions of people around the world have a diagnosis of hypertension high blood pressure what you may not know is that up to 20% of these people have something called secondary hypertension this is far too common to be so greatly underdiagnosed now what's the difference between

primary hypertension and secondary hypertension by far the most common diagnosis is primary hypertension or essential hypertension now what the average doctor means by this is that oh you have high blood pressure but we don't really know why you have high blood pressure what I found in my 22 years of clinical experience and reading tons of research papers is that primary hypertension essential hypertension is almost invariably caused by hyperinsulinemia and that's why a ketogenic diet or a carnivore diet which lowers your insulin back to low normal levels is so good at reversing primary or essential hypertension

now secondary hypertension is different there's actually a medical cause for secondary hypertension that your doctor should be looking for because remember we said one out of five people with high blood pressure have secondary hypertension this could be an endocrine problem with your hormones this could be a kidney problem this could be a thyroid problem this could be an adrenal problem so I'm going to go through this because the problem here is that many many Primary Care Health Care Providers either didn't learn about all the causes of secondary hypertension and what tests you would order to

diagnose them or they're so busy with essential hypertension because it's 80% of the cases that they see and then often they assume that the the other 20% of secondary hypertension is also essential hypertension doctors are taught in medical school that when you hear hoof beats you should think of horses not zebras and the meaning behind this is that you should always considered the most common cause of a disease or a condition and so when they hear hoof beats AKA your high blood your blood pressure is high multiple times when you're checking it properly at home

then you probably have 80% of the time it's primary or essential hypertension and they're right to think that but if your blood pressure is weird in some way and I'm going to get into the ways that secondary hypertension is weird compared to primary or essential hypertension later in this video then they should immediately start an investigation to look for causes of secondary hypertension and the things that they look for should be based on your age on your condition how high your blood pressure is how your blood pressure responds to the medications that they're trying to

lowerer it with I'm Dr Ken Barry a family physician let's talk about this hidden cause of high blood pressure that your doctor may not know about now let's first cover the signs and symptoms that your high blood pressure may be have a secondary cause the first starts on the physical exam which your doctor should do a thorough physical exam on you at least the very first visit and then typically once a year you should complete another thorough physical exam where they actually put their hands on you and examine your body and listen to you with

a stethoscope so if they detect that your arm tole systolic blood pressure is uh more than 20 points different that can be a sign of secondary hypertension if you have delayed or absent femoral pulses those are the pulses in your groin then that could be a sign of secondary hypertension if you have a heart murmur when's the last time your doctor listened to your heartbeat if you have an abdominal murmur called a brewery over the kidney arteries this can be a sign of second secondary hypertension if you have an any increase in your creatinine level

which is a kidney lab or any sign of kidney malfunction or dysfunction then that increases your risk that your hypertension is actually secondary hypertension now the reason we care so much about diagnosing teasing out secondary hypertension from primary hypertension is for two reasons one often can actually fix the underlying root cause of secondary hypertension rather quickly with a procedure or with a specific medication and then second if you have secondary hypertension that often puts you at risk of having another underlying undiagnosed medical condition that may be causing your secondary hypertension any indication of kidney disease

or kidney damage if you start an Ace inhibitor or an ARB these are blood pressure medications and you have a weird response to it or your your kidneys suddenly showing the blood work that you're these are damaging your kidneys that could be a sign of secondary hypertension if you you have a fast heartbeat or a slow heartbeat if you're feel always cold or you feel always hot if you have chronic constipation or chronic diarrhea if you have an irregular heavier absent menstrual period all those things can be a sign that you may have secondary hypertension

and should be investigated thoroughly if you have uh ever had a potassium measurement in your blood that's even one tenth of one point low that could be a sign that you have an underlying secondary cause of hypertension if you have apneic events during sleep if you stop breathing while you're asleep your bed partner says dude you stop breathing all the time if you have daytime sleepiness if you snore so loud that it wakes the neighbors up these can be signs of a cause of secondary hypertension if you have facial flushing if you have headaches if

you have blood pressures that are some days normal and some days super high if when you stand up your blood pressure goes very low if you have heart palpitations very frequently if you just have episodes where you sweat for no reason or if you have episodes where you either pass out or you almost pass out and those are repetitive those can be indications of secondary hypertension also if you have a a hump of fat on your neck known as a buffalo hump if you have you're very obese right in the middle of your body but

your arms and legs are kind of skinny if you have a very round face versus a nor more normal shaped face or if you have stretch marks for really no reason and and lots of very noticeable stretch marks these can all be signs of secondary hypertension now keep in mind that one out of every five people watching this video with high blood pressure has a secondary cause of that that could be corrected that needs to be discovered investigated diagnosed and treated and so this could be you and so if you have any of the symptoms

or signs I just went over if you have blood pressure that's still still high even though you're taking two or three or four different blood pressure medications you might have secondary hypertension and you need to have that investigated now to be very honest with you many Primary Care Health Care Providers are not knowledgeable enough to know which tests to check and so you might uh initially want to get this worked up with your primary care provider but if they don't find anything and you still Harbor a a suspicion that you're blood pressure is somehow weird

it's not acting right then you should probably ask for a referral to a Cardiologist who specializes in hypertension or even an endocrinologist so that you can be fully worked up and make sure that you don't have secondary hypertension when you've just been diagnosed with high blood pressure now remember earlier I said that it depends on your age as to which cause of secondary hypertension you might have in kids from 0 to 12 years years of age we're going to be really looking at the kidneys looking for an inborn uh renal defect or looking for coarctation

of the aorta in kids 12 to 18 years of age we're going to be looking again at the kidney very closely and at the aorta very closely and young adults from 19 to 39 years of age we're going to be looking at the thyroid we're going to be looking at fibromuscular dysplasia we're going to be looking again very carefully at the kidney to look at the the renal arteries and the kidneys themselves to make sure there's not a secondary cause of high blood pressure hiding in the kidneys for adults from age 40 to 64 we're

going to be looking at the adrenal glands aldosteronism is a very common cause thyroid dysfunction again in this age group obstructive sleep apnea yeah that can cause secondary hypertension foch chromosoma is an adrenal condition that can also lead to very severe secondary hypertension now an adult 65 years and of age and older we're going to be looking at atherosclerotic kidney disease so really looking at the renal arteries to see if there's a plaque buildup that's blocking the blood flow and that can cause severe hypertension we're going to be looking for signs of renal failure which

can also cause secondary hypertension as well and then hypothyroidism in this group now these categories based on the different age ranges are not set in stone if you have a a 10-year-old child who's severely severely obese and has high blood pressure they may have sleep apnea so just because you don't fall into one of these age categories this this warning goes for patients and for doctors just because you don't fall in that age category doesn't mean that you definitely cannot have that cause of secondary hypertension probably the most often missed cause of secondary hypertension is

primary aloster onism this is an adrenal hormone defect up to 10 to 15% of people with hypertension high blood pressure can have this and it's just hasn't been caught by their doctor another quite common cause is the renal perinal disease which is uh can can be glome nephritis polycystic kidney disease and and other kidney conditions as well this is probably 2 to 5% of people with high blood pressure they have kidney disease and their doctor just hasn't disced Ed it another is renovascular hypertension this is probably 1 to 2% of cases of of hypertension can

be caused by the narrowing narrowing of the artery supplying the kidney with arterial blood like renal artery stenosis and so it can be due to atherosclerosis but it can also be due to fibromuscular dysplasia and so this has to be teased out because if you have any of these secondary causes of hypertension first of all you're obviously at increased risk of heart attack and stroke because you have high blood pressure but secondly you also are not going to respond to the blood pressure medications because you don't have just essential hypertension which is going to respond

is 80% of cases and it's going to respond to a very low carbohydrate diet because it's essentially uh hyperinsulinemia and so that's why keto and carnivore work so great for for primary or essential hypertension but if you and and so so if any of you guys have adopted a proper human diet low carb keto ketovore carnivore and yet your blood pressure is still much much higher than it should be it has not returned to normal then that absolutely is a sign that you probably have a secondary cause of hypertension and you should talk to your

doctor about this if they feel comfortable working it up fine let them begin but you may need to wind up in a cardiologist office or an endocrinologist office who specializes in high blood pressure now here's another thing that you probably didn't know there's a pretty long list of medications that can cause secondary hypertension so this is a medication that your doctors prescribed for you for some other condition and one of the side effects of this medication is that it has raised your blood pressure to the point where you now are classify as having hypertension uh

any of the cyc oxygenase uh two inhibitors like celibre or celox and this is called different names in different countries that can cause H hypertension in some people and that's a secondary cause any of the nonsteroidal anti-inflammatory drugs uh ibuprofen neoen Al ibuprofen Advil Motrin korac tool any of the anti-inflammatories that you might take for a headache many of these medicines are over the counter also there's a large list of them that better prescription depending on which country you live in and so many doctors hand these out like candy almost for free like oh you've

got a headache here's a year worth of ibuprofen or generic celra or some other anti-inflammatory and these can act absolutely cause secondary hypertension another of the overthe counter more herbal things are a fedra jing and mahong these can cause high blood pressure in some people any amphetamin including the prescription amphetamines right like Aderall can cause eye blood pressure but then also any illegal amphetamine or cocaine any of the illicit drugs can cause secondary hypertension cyclosporin cimus and tacrolimus these are very uncommon medications but if you if you're taking if you're taking one you real you

recognize the name just then bupar used for depression and mental health issues can absolutely cause secondary hypertension integrity ol cleril lithium any of the monoamine oxidase Inhibitors used for mental health problems can cause secondary hypertension any of the ssris like Prozac paxel Zoloft Lexapro axer in some people can cause secondary hypertension any of the serotonin nor epinephrine reuptake Inhibitors again used for mental health issues can cause secondary hypertension and then also any of the tricyclic antidepressants can cause secondary hyper attention as well I'm not going to list all these but if you're taking an anti-depressant

or an anti-inflammatory you need to ask your doctor is it possible that this is contributing to my high blood pressure for the women if you are taking an estrogen pill or an estrogen progesterone combo these are notorious for causing higher blood pressure than you would have if you weren't taking them in many women this pushes you over the cut off for having hypertension and then you wind up taking a blood pressure medication or two or three but you really have a high blood pressure caused by your birth control pill or your menopause pill any of

the steroids whether it's prednizone solumedrol methyl pricone any of the steroids are going to have the potential to cause secondary hypertension and then also any over-the-counter or prescription anti-histamine or decongestant can cause secondary hypertension so if you're taking any of these things every single day for months and months and months they could be contributing to your hypertension although most people don't consider them to be drugs also keep in mind that chronic abuse of nicotine or alcohol can also lead to secondary hypertension now I've included some research down in the show notes if you want to

read further into this or maybe print that research out and take to your doctor so they'll know which test to actually order if you suspect that you have secondary hypertension if you have any kind of hypertension I would highly encourage you to adopt a proper human diet if you don't currently know what that is or what that means you can get my free guide book down in the show notes a proper human dieet guide book that tells you how to eat and enjoy all the benefits of a very low carbohydrate nutrient-dense ancestrally appropriate proper human

diet I have several other videos on this channel about high blood pressure and how you can improve it uh I'm going to put a link to my high blood pressure playlist down in the show notes but then also at the end of this video here in here some videos will pop up about hypertension if you want to learn even more hope this video helps this is Dr Barry I'll see you next time