Adult-Gerontology Clinical Nurse Specialist (CNS) Practice Exam

What is the most common cause of secondary hypertension?

1. Smoking

2. Sympathetic system stimulation

3. Vasodilation

4. Renal conditions

The correct answer is: Renal conditions

The most common cause of secondary hypertension is related to renal conditions. Secondary hypertension is defined as high blood pressure that is caused by an underlying condition, distinguishing it from primary hypertension, which has no identifiable cause. Renal conditions, particularly those that affect the kidneys' ability to filter blood and regulate fluid balance, are major contributors to secondary hypertension. For instance, conditions like chronic kidney disease can lead to dysregulation of the renin-angiotensin-aldosterone system (RAAS), resulting in increased blood volume and systemic vascular resistance, thereby elevating blood pressure. Renal artery stenosis is another specific renal condition that can cause secondary hypertension. This occurs when there is narrowing of the renal arteries, leading to reduced blood flow to the kidneys and subsequent activation of the RAAS, further promoting increased blood pressure. While other factors such as sympathetic system stimulation can contribute to hypertension, they are typically more relevant in primary hypertension or acute situations rather than being the common cause of secondary hypertension. The options of smoking and vasodilation, although related to blood pressure regulation, do not specifically represent the most common underlying cause in the context of secondary hypertension. Hence, renal conditions are recognized as the leading cause in this clinical context.