8 Common VA Secondary Conditions to Hypertension

If you have service-connected hypertension, you may be eligible for a higher VA disability rating—especially if your high blood pressure has caused or worsened another VA-ratable health condition.

The VA recognizes several secondary conditions to hypertension, including heart disease, kidney disease, and even erectile dysfunction (ED).

In this post, we’ll examine how high blood pressure can lead to VA-ratable secondary conditions, and how medical evidence like a nexus letter can help you increase your VA disability benefits.

Key Takeaways

• Hypertension often causes or worsens other chronic conditions such as heart and kidney disease and diabetes. 

• Veterans who develop secondary conditions, caused by service-connected hypertension may be eligible for a higher VA rating. 

• VA disability claims for VA secondary conditions to hypertension claims must show a link between the secondary condition and a veteran’s service-connected high blood pressure. 

• A Nexus Letter is one way to prove that high blood pressure was likely to cause or worsen another condition, such as heart disease. 

What is Hypertension?

Hypertension is a condition that causes high levels of pressure in the arteries, limiting normal blood flow and often damaging the inner lining of arteries and veins. This can cause blood vessels to become less elastic and more prone to narrowing or blockage.

According to the Centers for Disease Control and Prevention (CDC), 48.1% of U.S. adults live with high blood pressure—a chronic condition that disproportionately affects veterans due to unique service-related stressors, lifestyle factors, and environmental exposures.

As hypertension causes blood vessels to narrow, blood flow becomes limited to the heart and other organs, increasing the risk of cardiovascular (i.e., heart and blood vessel) disease. When these associated disorders develop, they are often considered secondary conditions—which may qualify veterans for a higher VA disability rating.

8 Common VA Secondary Conditions to Hypertension

Hypertension is known to cause or worsen several other severe conditions, such as vascular disorders, heart conditions, and more. Common secondary conditions associated with hypertension include: 

Heart Disease

High blood pressure increases the risk of coronary artery disease (CAD), heart attacks, and stroke. CAD is the most common type of heart disease in the U.S. and a leading cause of death in men and women. 

Chronic Kidney Disease (CKD)

Hypertension damages blood vessels in the kidneys, impairing their ability to function properly. When uncontrolled or untreated, high blood pressure can cause kidney failure. 

Peripheral Artery Disease (PAD)

Hypertension can increase the risk of peripheral artery disease, such as atherosclerosis (i.e., hardening of the arteries). 

Stroke

Hypertension can increase the risk of stroke either from occluding normal blood flow to the brain, or by damaging blood vessels which could cause them to burst (i.e., hemorrhagic stroke). 

Erectile Dysfunction (ED)

As hypertension damages blood vessels, it limits blood flow throughout the body, making it difficult to get an erection. 

Sleep Apnea

Hypertension can cause an increase of fluid in the throat, exacerbating (worsening) obstruction of breathing during sleep, which can cause more frequent and severe sleep apnea episodes. 

Eye Disorders

Hypertension can contribute to eye conditions, such as retinopathy. Retinopathy is a condition which occurs as a result of damaged blood vessels in the back of the eye (i.e., the retina). 

Aneurysms

Hypertension can cause bulges to occur in arteries which can cause dangerous bleeding or death if they burst. 

Other Conditions Secondary to Hypertension

Additionally, there are other conditions that can be caused or worsened from undiagnosed, uncontrolled or untreated hypertension. These hypertension secondary conditions include:  

• Angina – Chest pain, resulting from lack of sufficient blood flow to the heart. 

• Cognitive impairment and dementia – A neurological condition that can occur when blood flow to the brain is disrupted by hypertension. This lack of adequate blood flow to the brain can result in small strokes and contribute to atrophy (i.e., shrinkage) of the brain’s white matter. Untreated or uncontrolled hypertension can eventually impair cognitive functions like memory and reasoning or contributing to a certain type of dementia (i.e., vascular dementia)  

• Left ventricular hypertrophy (LVH) – Hypertension that causes the heart’s left ventricle to thicken and enlarge, making it difficult to pump oxygenated blood throughout the body.  

• Pulmonary hypertension – Abnormally high blood pressure in the arteries of the lungs causes the heart to work harder to pump oxygenated blood throughout the body, which can damage the heart muscle. 

• Microvascular disease (i.e., small vessel disease) – A type of heart disease that can lead to capillary, arteriole, or venule spasms and reduced blood flow to the heart from these microvessels (i.e., the smallest blood vessels in the heart).

How the VA Rates Secondary Conditions to Hypertension

The VA rates secondary conditions the same way it rates primary conditions—based on the severity of the secondary condition itself, using the standard VA disability rating criteria for that illness or injury.

To receive a rating, you must establish secondary service connection. This means that your secondary condition must be clearly linked to your service-connected hypertension through medical evidence, often supported by a credible nexus letter.

Establishing Secondary Service Connection

The VA requires that veterans must service-connect their condition(s) to receive VA disability compensation and benefits. In order to possibly receive a VA rating for a secondary condition to hypertension, you need to be service connected for hypertension. This is because secondary service connection requires a primary service connection. 

Service Connecting Secondary Conditions to Hypertension

Items that can prove service connection include: 

• A current service-connected primary diagnosis of hypertension 

• A current medical diagnosis of your VA-ratable secondary condition, performed by a qualified healthcare provider 

• Documentation of supportive evidence such as in your medical and/or personnel records, reviewed by your provider.  

• A medical nexus (documented evidence that your hypertension caused or worsened your secondary condition); a nexus letter often serves as a medical nexus.  

How a Nexus Letter Can Strengthen Your Secondary VA Claim

You may qualify for a higher VA disability rating if you can prove your service-connected hypertension caused another medical condition or worsened a preexisting one. 

A Nexus Letter, written by a qualified healthcare provider is one way to prove that your high blood pressure was likely to cause or worsen another condition.   

Unless there is a definitive connection between your hypertension and a secondary condition, a nexus letter is often needed to show service-connection. 

Conclusion

High blood pressure doesn’t always come alone. For many veterans, hypertension is just the beginning of a longer health journey—one that may include heart complications, kidney issues, or other serious conditions.

If your service-connected hypertension has led to new health problems or worsened existing ones, you may be eligible for a higher VA disability rating.

FAQs | Frequently Asked Questions

Do I need to be service-connected for hypertension before claiming a secondary condition?

Yes. You must first be service-connected for hypertension in order to claim any related secondary conditions.

What’s the best way to prove a secondary connection to hypertension?

A medical nexus letter from a qualified provider is often the most effective way to establish a link between your hypertension and a secondary condition.

Will the VA automatically consider secondary conditions when rating my hypertension?

No. The VA generally does not assess or award ratings for secondary conditions unless you specifically claim them and submit supporting evidence.

Can secondary conditions develop years after service?

Yes. Some secondary conditions can take years to develop. You can still claim them as secondary as long as you have a service-connected primary condition and strong medical evidence.

Medical Evidence Wins VA Claims

Did you know that a lack of medical evidence is the #1 reason VA disability claims are denied?  

Medical evidence is a crucial piece of the puzzle that VA raters consider when reviewing a disability claim. Telemedica provides solutions for veterans looking to bolster their claims through high-quality medical evidence that wins claims!  

Schedule your 20-minute consultation, get answers for your service-connected disability, and start on your path to well-being.