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Inherited High Blood Pressure in a Teenager

Essential (primary) hypertension, which is high blood pressure of unknown cause, generally develops in the middle years. Theonset of hypertension in the teenage years or after the age of sixty, therefore,should raise a question about its underlying cause. Could the elevated bloodpressure be secondary to kidney (renal) disease, a disruption in the bloodcirculation to the kidneys (renal artery blockage), or an adrenal gland hormone abnormality?

I recently saw a healthy appearing, athleticteenage boy in consultation. He had developed the recent onset of hypertensionto as high as 180/110. The normal blood pressure in this age group is well under140/90. Because of his young age, this patient had already had what was thoughtto be a complete medical workup to diagnose or exclude (rule out) the secondarycauses of hypertension. He had also had a heart evaluation. In fact, anultrasound exam of his heart (echocardiography) showed no enlargement yet fromthe hypertension.

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