If you’ve been diagnosed with high blood pressure (hypertension), your treatment likely started with your primary care physician. You’re probably focusing on diet, exercise, and taking your prescribed medications. But what happens when these measures aren’t enough? What if your blood pressure remains stubbornly high, or there are other unusual symptoms?
In these cases, the root cause of your high blood pressure might not be in your heart or blood vessels, but in your endocrine system. This is when consulting an endocrinologist (a specialist in hormone-related conditions) can be an important step.
This guide will explain the connection between your hormones and your blood pressure, and help you understand when it’s time to seek an endocrinologist.
Primary Care and Cardiology
For the vast majority of patients, high blood pressure is managed effectively by a primary care physician (PCP). Your PCP diagnoses the condition and prescribes initial lifestyle changes and medications. If your condition is complex or you have other cardiovascular risk factors, you may be referred to a cardiologist (a specialist in heart and blood vessel diseases).
This is the standard treatment path for most people. But a subset of hypertension cases don’t respond to standard treatment because they have a different underlying cause.
Primary vs. Secondary Hypertension
There are two main types of high blood pressure:
- Primary (Essential) Hypertension: This is the most common type, accounting for about 90-95% of all cases. It has no single identifiable cause and develops gradually over the years due to a combination of genetics, diet, lifestyle, and age.
- Secondary Hypertension: This type accounts for the remaining 5-10% of cases and is caused by an underlying, identifiable medical condition. When that condition is treated, blood pressure often improves or returns to normal.
Many of the conditions that cause secondary hypertension are endocrine disorders. According to the American Heart Association (AHA), identifying and treating these underlying causes is key to managing secondary hypertension.
How the Endocrine System Controls Blood Pressure
Your endocrine system is a network of glands that produce and release hormones. These are powerful chemical messengers that regulate everything from your metabolism and mood to your sleep and, critically, your blood pressure.
Several hormones play a direct role in maintaining healthy blood pressure by controlling fluid balance, blood vessel constriction, and your body’s stress response. When a gland produces too much or too little of a specific hormone, this delicate balance is disrupted, leading to high blood pressure.
Common Endocrine Conditions That Cause High Blood Pressure
An endocrinologist will check for these hormonal imbalances:
- Primary aldosteronism: The adrenal glands produce excess aldosterone (a hormone that controls salt balance). This causes the body to hold onto salt and water, which increases blood pressure.
- Thyroid disease: Both overactive thyroid (hyperthyroidism) and underactive thyroid (hypothyroidism) can disrupt heart function and raise blood pressure.
- Cushing’s syndrome: The body makes too much cortisol, a hormone linked to stress. Over time, this extra cortisol causes the body to hold onto fluid and makes blood vessels tighter, which raises blood pressure.
Signs You Should Consider Seeing an Endocrinologist for Blood Pressure
Here are the most common situations where an endocrinology evaluation makes sense.
- Blood pressure stays high even with medication.
- Potassium levels are low.
- High blood pressure starts at a young age.
- Blood pressure suddenly worsens.
- Symptoms suggest a hormone problem, such as episodes of sweating, pounding heart, or severe headaches.
What to Expect at Your Endocrinology Consultation
During an endocrinology evaluation for high blood pressure at Hilltop Internal Medicine and Endocrinology, our goal is to find a precise diagnosis. Your visit will likely include:
- A Detailed Medical and Family History: We’ll discuss your symptoms, lifestyle, and all medications you take.
- A Comprehensive Physical Exam: We’ll look for physical signs that may point to a specific endocrine disorder.
- Targeted Lab Testing: We will likely order specific blood and urine tests to measure your hormone levels and check for imbalances.
- Possible Imaging: Depending on the initial findings, we may order an MRI or CT scan to look for tumors or abnormalities in your adrenal or pituitary glands.
When to Get Urgent Care
If your blood pressure is very high and you have any of the following symptoms, seek immediate medical care:
- Chest pain
- Shortness of breath
- Severe headache
- Weakness
- Confusion
- Vision changes
Consult Our Endocrinologist
If you and your doctor suspect your high blood pressure may be linked to a hormonal issue, we are here to help. Contact Hilltop Internal Medicine and Endocrinology today by calling (301) 567-9570 to schedule an evaluation.
FAQs
Can an endocrinologist treat high blood pressure?
Endocrinologists can treat high blood pressure when it is linked to hormones (adrenal or thyroid issues). Many patients still keep their primary care clinician involved for ongoing blood pressure medication management.
What is the most common endocrine cause of high blood pressure?
The most common endocrine cause of high blood pressure is primary aldosteronism.
