Investigating hypertension in a young person

doi:10.1136/bmj.b1043

Published 6 April 2009, doi:10.1136/bmj.b1043
Cite this as: BMJ 2009;338:b1043

Practice

Rational Testing

Investigating hypertension in a young person

Fabian Hammer, MRC research training fellow, Paul M Stewart, professor of medicine

¹ Institute of Biomedical Research, Division of Medical Sciences, University of Birmingham, Birmingham, B15 2TT

Correspondence to: P M Stewart, Professor of Medicine, Institute of Biomedical Research, Division of Medical Sciences, University of Birmingham, Birmingham B15 2TT p.m.stewart@bham.ac.uk

Where do you start when checking for secondary causes of hypertensionin a young adult? This article will guide you through key testsand imaging techniques

The first 150 words of the full text of this article appear below.

A 27 year old man with a six month history of mild but progressiveheadache visited his general practitioner and was found to havea blood pressure of 178/108 mm Hg. He had an unremarkable medicalhistory, but his father had had high blood pressure and haddied from a stroke at age 45 years. Clinical examination witha particular emphasis on the cardiovascular system includingfunduscopy was unremarkable, and no renal artery bruit was heard.Basic laboratory tests at his general practice were all normal(sodium 144 (normal range 135-145) mmol/l; potassium 3.8 (3.5-5.1)mmol/l; creatinine 105 (60-110) µmo/l; urea 5.4 (2.9-9.4)mmol/l), with no proteinuria.

Arterial hypertension warrants further investigations to excludesecondary causes of hypertension in young people (aged <40years), those with blood pressure resistant to antihypertensivetreatment, and those with a family history of hypertension orstroke at age <50 years. Furthermore, a detailed social . . . [Full text of this article]

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