原发性高血压占高血压病人中的80％,继发性高血压占20％,这一比数与各地的诊断技术水平有关。本文重点介绍继发性高血压的鉴别诊断。一、继发性高血压的病因分类 (一)收缩期高血压:1.心排出量增加者:主动脉瓣关闭不全、动脉静脉瘘、动脉导管未闭、甲状腺机能亢进、、重度贫血等。2.主动脉粥样硬化性高血压(老年人高血压病)。 (二)收缩期、舒张期高血压:1.肾性高血压:(1)肾血管性高血压(单侧或双侧)①先天性:(1)肾动脉发育不全、动静脉瘘等。②后天性:大动脉炎、动脉硬化及钙化、肾动脉血栓或栓 Essential hypertension accounts for 80% of hypertensive patients and 20% of secondary hypertension, which is related to the level of diagnostic skills around the country. This article focuses on the differential diagnosis of secondary hypertension. First, the etiology of secondary hypertension (a) systolic hypertension: 1. increased cardiac output: aortic insufficiency, arteriovenous fistula, patent ductus arteriosus, hyperthyroidism, severe anemia and so on. Aortic Atherosclerotic Hypertension (Elderly Hypertension). (B) systolic and diastolic hypertension: 1. Renal hypertension: (1) Renal vascular hypertension (unilateral or bilateral) ① congenital: (1) renal artery hypoplasia, arteriovenous fistula and so on. ② Acquired: arteritis, arteriosclerosis and calcification, renal artery thrombosis or thrombosis