English

Abstract

Hypertension in childhood and adolescence is usually secondary to underlying causes like renovascular, renal-parenchymal, cardiovascular and endocrine diseases. Persistent hypertension in paediatric age group is a diagnostic and therapeutic challenge. Sleep disordered breathing or Obstructive sleep apnea in adolescence can present in numerous nonspecific ways. Whether sleep disordered breathing can solely be a cause of persistent hypertension in adolescence is doubted. We report a case of a 13 year old boy with history of persistent hypertension inadequately controlled even with multiple antihypertensive drugs. A thorough history, physical examination and rational investigations were performed to rule out causes of secondary hypertension. The patient was obese and obstructive sleep apnea was identified on the basis of history and sleep studies. He was titrated on continuous positive airway pressure (CPAP) for obstructive sleep apnea and put on a weight loss regimen. Amelioration of symptoms and adequate blood pressure control was obtained. We concluded that hypertension in adolescence may be caused or aggravated by sleep disordered breathing and a specific treatment approach may help in relieving symptoms and achieving adequate blood pressure control especially when no other etiology or risk factors can be identified.