Journal
MEDICAL CLINICS OF NORTH AMERICA
Volume 108, Issue 1, Pages 157-172Publisher
W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1016/j.mcna.2023.06.005
Keywords
Monogenic hypertension; Renin; Aldosterone; Liddle syndrome; Congenital adrenal hyperplasia; Apparent mineralocorticoid excess; Gordon syndrome; Adolescent
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Hypertension in adolescents is rare, and evaluation for identifiable causes beyond primary hypertension is necessary. Common causes of hypertension in this age group are usually acquired or congenital renal or vascular diseases. If these etiologies are not found, exploration for rare causes, including monogenic hypertension, should be pursued.
Hypertension in an adolescent in uncommon and deserves evaluation for identifiable causes other than primary hypertension. Usual causes of hypertension found in this age group are most often from an acquired or congenital form of renal disease or vascular etiology. If no such etiology is found, then exploration for rare causes of hypertension need be pursued, including for monogenic causes of hypertension. Several monogenic etiologies of hypertension are well defined, but are exceedingly rare and thus may not be recognized in a hypertensive adolescent unless considered. A few biochemical screening tests may provide clues toward a potential monogenic etiology of hypertension in such cases. Precise diagnosis of a monogenic cause of hypertension in most cases requires genetic analysis. Identifying a monogenic cause of hypertension is essential in those who have not been found to have more common identifiable causes of hypertension in adolescents, since treatment strategies for these rare conditions are specific and different from antihypertensive regimens for the other more common causes of hypertension in this age group.
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