Clinical Study on Juvenile Hypertension

Abstract

From the relatively high rate of uremic death observed in young hypertensives it is clear that the liability to develop malignant hypertension in those young subjects is considerable and the recognition and treatment in the early stages of the disease is important. In order to study these young hypertensives, especially those with juvenile arterial hypertension (defined as juvenile hypertension), 209 hypertensive patients under 40-year old were selected from 7176 patients studied at the second medical clinic of Juntendo University Hospital from 1957-to 1966. The diagnostic criteria of hypertension were bases on BP values above 150/90mmHg at rest in the lying position. The distribution of various hypertensive states among these patients was as follows. [table]To investigate the possible mechanisms involved in the development of juvenile hypertension together with the clinical pathological findings, the results of precise clinical examinations of these patients were summarized and compared with the findings in chronic gromerulonephritis and in arterial hypertension of older age groups. The characteristics of juvenile hypertension were as follows. 1) There are two types of juvenile hypertension, namely a labile hypertension (A type) and a sustained hypertension (B type). 2) The relative incidence of hypertension in the family history was markedly higher than that of chronic glomerulonephritis. 3) The subjective symptoms of these patients were relatively slight and were limited to CNS symptoms as headache, dizziness or shoulder-stiffness. 4) The urinary findings, renal function tests, blood pictures and the biochemical patterns were relatively normal except for the consistent finding of a lower level of serum potassium especially in the A type. 5) The catecholamines, especially noradrenalin, excretion in the urine were increased, particulary in the A type.