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Date of last update: 10/20/2017.

Forum Name: Hypertension

Question: pediatric hypertension- no diagnosis despite many tests

 sweetiethekitty - Sun Mar 16, 2008 8:21 am

Thank you so much for providing this forum. My 11 year old daughter has been diagnosed with hypertension- unmedicated, her blood pressure is around 150/105. She is 4 feet 4 1/2 inches and weighs 92 lbs. As an infant, she had urinary reflux, a partially paralyzed vocal cord, and RSV. She does not have any of those conditions anymore.

We were admitted to the hospital with a reading of 189/115, and stayed for 4 days until they could stabalize her numbers.

While there, and for the 2 month following, she took many tests, all of which turned out normal. (Renal sonograms, MRI, 24 hr. urine test, EKG, lots of bolld work). Last week she had a renal angiogram, which was also normal.The doctor took renin samples, and we don't have those results yet.

I am nervous to just accept the fact that "she just has high blood pressure", and I am not excited about medicating her for the rest of her life. I am considering trying some kind of alternative (herbal) medications.

We have tried losing weight, but that does not have any effect on her numbers. She takes 5 mg amlodopine, 2x daily and 5 mg lapidolol, 2x daily. On her medication, her blood pressure is around 112/64. She still complains of stomachaches (almost daily), and has trouble holding her bladder at night. We saw a urologist who put her on a urination schedule. I'm not sure if that is helping at all.

Is there something we are overlooking? Thank you so much for your help.
 Dr. A. Madia - Tue Mar 18, 2008 9:05 am

User avatar Hi,

First of all you have my full sympathy on your young kid having hypertension at an early age. Hypertension in children though rare, is not unheard of and infact many of young adult hypertensives could actually be child hypertensives gone undetected.

Hypertension is of two types. Primary and Secondary. Secondary hypertension, is the more ominous one. It has a 'Cause' like a kidney disease, an endocrine disease etc. These causative diseases are mostly of serious nature and cause some reduction in life expectancy.

When all the tests done to check for such a 'Cause' of the BP come normal as in your daughter's case, it is called Primary Hypertension. It is just there. There is no underlying kidney infection, kidney stone, hormone imbalance etc.

Now that your daughter does have primary hypertension, it will be counter productive just to deny it or trying an escapist route. Beacuse then she will land up in some complication of hypertension like retinal damage, brain or kidney damage, heart disorder etc. It is wise to face it head on and keep taking the treatment to control it.

I would suggest though, looking at the doses and the BP of 112/64 after the doses to talk to your physician if she would agree to reduce some doses so as the BP could remain in the range of 120/80 and the side effects like excess urination, [can be caused by amlodipine] could be avoided.

 sweetiethekitty - Tue Mar 18, 2008 12:07 pm

Hi, Dr. Madia- thank you so much for your quick response. Her nephrology team wanted to keep the pressure as low as possible, (that's why they added the Lapidolol), but I really hate to give her excess medication, so I will address the issue with them again.

Meanwhile, a pediatrician friend of mine thought maybe my daughter should see an endocrinologist. Do you feel that is necessary?
 hmharrison - Mon Jun 01, 2009 12:38 am

wow, that sounds just like my sons issues. He was Dx with hypertension at 2 months 2 and half now, However they can not find anything wrong with him. I worry nonstop that they are missing something and one day something horrid will happen. He now takes amlodipine once a day, which keeps his BP stable. I hate taking him for testing over and over to still have no answers.

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