Introduction: Hypertension in young people is secondary, but stress could be an important risk factor for hypertension and heart disease complications over time.
Case report: A 21 year-old patient presented for high blood pressure values in the last two months. He was non-smoker and he had no medical history. Physical exam: normal weight, blood pressure (BP) 160/90 mmHg. Laboratory tests: mild hypercholesterolemia.
Abdominal ultrasound: hypotrophic left kidney. Ambulatory BP monitoring confirmed diurnal high
BP, with more than 47% of diurnal values greater than 140 mmHg. Contrast enhanced CT scan and angiography showed two left renal veins, one of them over the artery, but with normal caliber of the left renal artery.
Discussion: A lot of studies revealed that stressful work increased systolic blood pressure and heart rate reactivity and decreased vagal tone. The high BP values occurred in conditions of a job with a lot of stress to a young patient with a left kidney malformation, but with normal renal function. The slight increase in serum cholesterol and cortisol confirms this hypothesis. We could not find any other cause of secondary hypertension.
Conclusion: Nowadays, stress is responsible for many physiological changes, including constant increase in blood pressure. The scale of cardiovascular risk should be reevaluated in young people through proper trials.
Keywords: arterial hypertension, stress, kidney malformation
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Alice Balaceanu, MD, PhD
Department of Internal Medicine, Clinical Emergency Hospital “Sf. Ioan“,