History in the child or adolescent with elevated blood pressure

History	Possible cause of hypertension
Central nervous system – Head trauma, headache, visual disturbance, lethargy, seizures, tremors, morning vomiting	Elevated intracranial pressure
Hearing – Hearing loss	Kidney disease (ie, Alport syndrome) Lead poisoning
Cardiovascular – Palpitations, irregular pulse	Catecholamine excess
Kidney – Edema, history of urinary tract infection or unexplained fever, abnormal urine color, enuresis, flank pain, dysuria	Kidney disease or condition (eg, pyelonephritis, acute glomerulonephritis, acute kidney injury, chronic kidney disease)
Skin – Rash, sweating, pallor	Catecholamine excess Thyroid dysfunction Renal vasculitis
Recent medical history – Recent pharyngitis or impetigo, exposure to sources of enterohemorrhagic Escherichia coli	Postinfectious glomerulonephritis Hemolytic uremic syndrome
Medications – Sympathomimetics, oral contraceptives, corticosteroids	Side effect of medication
Substance use – Cocaine, amphetamines, anabolic steroids, phencyclidine, ephedra-containing alternative medications, caffeine	Drug-mediated effects
Family history – Hypertension, early myocardial infarction, diabetes, stroke	Essential hypertension
Sexual history – Postmenarchal female actively engaged in sexual intercourse	Preeclampsia
Neonatal history – Use of umbilical artery catheters	Renovascular hypertension
Growth history – Excessive weight gain or loss, change in growth percentiles	Obesity, thyroid dysfunction
Dietary history – Types and amount of food ingested, salt craving	Obesity, essential hypertension
Social history – Stress factors at home and school	Stress

Graphic 76420 Version 10.0

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History in the child or adolescent with elevated blood pressure