Dylematy terapeutyczne u nastoletniego sportowca z nadciśnieniem tętniczym

Ewa Smereczyńska, Barbara Wójcicka-Urbańska, *Bożena Werner

Summary
The authors report a history of a 14-year-old athlete admitted to the Department of Cardiology due to home and ambulatory high blood pressure measurements. The patient complained of corresponding headaches. He had good excersise tolerance. He had no chronic diseases and did not take any medication. He denied using anabolics, energetic drinks or steroides. Physical examination revealed his height and weight over 97 centile and body mass index (BMI) over 85 centile. Standard blood pressure (BP) measurement was 140/70 mmHg (systolic over 95 centile). He underwent the diagnostic process to exclude white coat and secondary hypertension as well as organ damage. In ambulatory blood pressure monitoring (ABPM) increased systolic blood pressure was registered. Abdomen ultrasound with renal arteries Doppler ultrasound showed no abnormalities. Blood and urine tests allowed to exclude pheochromocytoma as well as kidney and thyroid gland diseases. Urinary albumin concentration and also glucose and lipids serum concentration were normal. The first line management was non pharmacological treatment which was unsuccessful. As a next step pharmacological treatment was introduced however no permanent result was achieved. The regular checkups revealed increasing BMI with concomitant hypertension despite regular work out.

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