Sains Malaysiana 49(1)(2020): 129-132

http://dx.doi.org/10.17576/jsm-2020-4901-15

 

Essential Hypertension Onset in a 12-Year-Old Adolescent

(Permulaan Tekanan Darah Tinggi pada Remaja 12 Tahun)

 

MOHD SHAIFUL EHSAN SHALIHIN1*, ZULKIFLI HARUN2 & ISKANDAR FIRZADA OSMAN2

 

1Department of Family Medicine, Kulliyyah of Medicine, International Islamic University of Malaysia, IIUM Kuantan Campus, Jalan Sultan Ahmad Shah, 25200 Kuantan, Pahang Darul Makmur, Malaysia

 

2Klinik Kesihatan Jaya Gading, Jaya Gading, 25150 Kuantan, Pahang Darul Makmur, Malaysia

 

Received: 20 August 2019/Accepted: 17 October 2019

 

ABSTRACT

Essential hypertension in adolescents is increasing in trend worldwide in view of increasing prevalence of childhood obesity and sedentary lifestyle. Generally, secondary hypertension is suspected if it occurs at pre-pubertal age or presented with resistant hypertension. We reported a case of 12-year-old adolescent male diagnosed with essential hypertension during opportunistic screening with suboptimal blood pressure control at primary care. Poor response of his blood pressure control despite his compliance to medications had cause him emotional distress. We referred this child for assessment of secondary hypertension but it turned out to be negative. Surprisingly, his blood pressure responded well with prazosin and diltiazem combination during adjustment period prior to renovascular assessment. His hypertension is well controlled till now. This case proved that essential hypertension is still possible in early non-morbid obese adolescent despite negative family history of hypertension. Individualised treatment should be adapted rather than questioning the compliance of the adolescent.

 

Keywords: Adolescent; diltiazem; hypertension; prazosin

 

ABSTRAK

Kes tekanan darah tinggi dalam kalangan remaja semakin meningkat oleh kerana peningkatan kes kegemukan dan pengamalan gaya hidup yang tidak sihat sejak daripada usia kanak-kanak. Secara umumnya, tekanan darah akibat punca kesihatan yang lain perlulah dikenal pasti terutama jika tekanan darah tinggi terjadi pada usia sebelum akil baligh atau pada keadaan tekanan darah yang sukar untuk dikawal.  Kami sertakan laporan kes berkaitan remaja lelaki berusia 12 tahun yang telah dikenal pasti mengalami tekanan darah tinggi yang sukar untuk dikawal secara optimum di klinik kesihatan. Kawalan tekanan darah yang tidak berkesan biarpun telah mematuhi pengambilan ubat yang disyorkan telah mengakibatkan tekanan emosi kepada remaja ini. Justeru kami telah merujuk remaja ini kepada pihak hospital namun rawatan susulan mendapati remaja ini tidak mempunyai masalah lain berkaitan darah tinggi beliau. Tanpa dijangka, bacaan tekanan darahnya menjadi terkawal dengan pengambilan ubat prazosin dan diltiazem sebelum menjalani penilaian fungsi saluran darah buah pinggang. Ternyata tekanan darahnya menjadi terkawal sehingga sekarang. Kes ini berjaya membuktikan tekanan darah tinggi boleh terjadi pada usia awal remaja yang tiada masalah obesiti mahupun tiada sejarah darah tinggi keturunan. Pencarian ubat darah tinggi yang sesuai untuk kawalan darah tinggi dalam kalangan remaja perlulah menjadi keutamaan berbanding mempertikaikan kejujuran remaja dalam mengambil ubat seperti yang telah ditetapkan. 

 

Kata kunci: Darah tinggi; diltiazem; prazosin; remaja

 

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*Corresponding author; email: shaifulehsan@iium.edu.my

 

 

 
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