Hello Doctor,
How should a 16-year-old boy with stage 2 hypertension, no medical history, no medications, no alcohol or drug use, and a healthy diet, but slightly elevated BMI with most body mass as muscle, manage his condition?
Hello,
Thank you for reaching out to Dr. Galen. Please find the below response to your query.
Evaluation for Secondary Causes of Hypertension in Adolescents:
Hyperthyroidism:
Increased metabolism and heart rate can contribute to hypertension.
Symptoms: weight loss, increased appetite, palpitations, tremors.
Tests: thyroid function tests, thyroid ultrasound or scans if needed.
Pheochromocytoma:
Rare adrenal tumor causing excess catecholamines and hypertension.
Symptoms: headaches, palpitations, sweating, episodic hypertension.
Tests: 24-hour urine catecholamines and metanephrines, plasma-free metanephrines, imaging (CT/MRI).
Pituitary Tumors (Cushing's Syndrome):
Excessive cortisol production leading to hypertension.
Symptoms: weight gain, central obesity, thinning skin, muscle weakness.
Tests: cortisol level measurements, pituitary MRI if indicated.
Thanks
