Hypertensive Crises in the Adolescent: Evaluation of Suspected Renovascular Hypertension
Abstract: Hypertensive crises
can be divided into two categories as hypertensive emergency and hypertensive
urgency. Most authorities have defined hypertensive emergency as a situation
that requires immediate reduction in blood pressure (BP) with parenteral agents
because of acute or progressive target organ damage, whereas hypertensive
urgency is a situation with markedly elevated BP but without severe symptoms or
progressive target organ damage, wherein the BP should be reduced within hours,
often with oral agents. Adolescent with hypertension should be suspected of
having renovascular hypertension in spite of other causes.
This case is presenting a 16-year-old boy with hypertensive crises due to
suspected renovascular hypertension. His blood pressure was 240/120 at
admission with hypertensive retinopathy grade III and there was increase in
creatinine after administering ACE-inhibitor but his renal arteriography
revealed normal, other physical examination and laboratory findings was normal.
Regarding these findings, the conclusion was this patient got essential
hypertension. As many hypertensive crises occur in any ages, clinicians should
aware the possibility of renovascular hypertension in young patients with
hypertensive crises. An early detection and urgent treatment are needed to
prevent the implication of progressive target organ damage.
Key words: hypertensive
crises, adolescent
Author: Indra Wijaya,
Parlindungan Siregar
Journal Code: jpkedokterangg130282
