Doctors Lounge - Cardiology Answers
Forum Name: Hypertension
Question: High Blood Pressure in a 14 year old?
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|logicaldog - Wed Oct 14, 2009 3:24 am||
My son just turned 14 and went in for a sports physical and his blood pressure was high 160/90, he had just eaten. His diet is less than desireable-he doesn't eat red meat but alot of chicken sandwiches. (he had just had mcdonalds chicken sandwich right before blood pressure was taken), eats alot of carbs (I try veggies and fruits, some success...), when we got home it varied from 118/78-140-89! I am a psychotherapist and my husband used to be a respiratory therapist (so he knows how to take blood pressure)...
A little history-he was small when born (5 lbs), with no risk factors and an almost perfect APGAR. (went right home no health problems), but I had ALOT of stress when pregnant (my mother died suddenly, not health related...). He has had no health problems other than a urinary tract infection when he was 7. (they didn't see any irregularities in kidneys...) but I know it is rare in a boy but in reading can occur. His height and weight are a little under 50th percentile now. He doesnt get any exercise other than PE and volleyball (thus the need for sports physcial to do crew which would be excellent exercise)
I must say I have NO trust in the healthcare system (as a provider), and I am VERY reluctant to engage the system. (and I think providers do not understand the real degree of horrific results this sytem reeks on human beings) Going to a doctor or a hospital puts your life at risk, in my opinion, and should be done only with extreme caution. Your thoughts?
|John Kenyon, CNA - Fri Oct 30, 2009 11:09 pm||
Hello -- Your son would seem to have a possible endocrine problem, quite possibly pheochromocytoma (an often tiny adrenal tumor which may be located on one of the glands but which can also be found in almost any area inside the viscera at times). This is but one possibiity and it may be a lot simpler, but is always best to rule out the most problematic and/or serious issues first. Since there seems to be no other good reason for this elevated BP (diet may not be ideal but doesn't sound horrible either), my first thought is to eliminate renal and adrenal issues as possible cause, at which point the problem may require temporary symptomatic treatment to manage the BP while the underlying cause is determined.
While I recognize there are problems in the US healthcare system, I feel most of those problems are organizational/systematic, and so retain a great deal of confidence in the great majority of providers, who are also struggling to find ways around the constraints places upon them by health insurance providers. The essential product, the care rendered, hasn't suffered as much as has access to it. So I can't agree with your conclusion that seeing a doctor or being hospitalized constitutes an automatic risk to one's life. Believe me, virtually all providers are more than aware of the problems the system sometimes wreaks on the patient population, as much of this is simply placing limitations on what a doctor can do that is appropriate and necessary vs. what a CEO feels is most cost-effective. While having a competent patient advocate is always a very helpful thing (you being a healthcare professional allows you some insights into the process others might not enjoy), I've worked in the acute/emergent/critical care areas for a very long time and have tremendous confidence in the abilities of most providers and nursing staff so far as they are allowed to practice their art. The system itself is a problem, hopefully on the verge of major reform, but the essentials remain the same, and elevated BP in a 14 year old is unusual enough to be worrisome and warrant at least further exploration, either by an internist or a team effort if need be, including endocrinologist and urologist, depending upon where initial testing points, and one of the first tests should probably be a 24 hour urine test to look for excess adrenaline in the urine, which would point toward pheochromocytoma -- a usually benign and often quite manageable problem. It's just a guess, we're working at a distance and in cyberspace, but this seems, given your son's youth, one of the more likely possibilities among several.
I hope this is helpful. Please follow up with us here as needed, and do update us as you learn more. Good luck to you and to your son.
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