ABSTRACT
Secondary hypertension dominated thought about the causes, mechanisms, and even treatment of all hypertension, because before the advent of effective and tolerable antihypertensive drugs in the late 1950s, it was almost the only area within which rational treatment seemed possible. Experimental renovascular high blood pressure in rats does not lead to insulin resistance, so the pathways of renal hypertension and at least one large subset of primary high blood pressure are distinct, but obviously in humans they may be mixed. High blood pressure develops in about 80% of cases, but is rarely severe. Stenosis or occlusion of a renal artery has been said to be the commonest form of unilateral renal disease causing secondary high blood pressure, possibly accounting for up to 4% of all hypertensive, about 200,000 people in the whole of Britain. High blood pressure is 50–100% more common than in the general population in both symptomatic and biochemical hypothyroidism.
