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Q. Why is my blood pressure very high although tests are normal?

Answered by
Dr. Mashfika N Alam
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on May 12, 2018 and last reviewed on: Aug 27, 2020

Hello doctor,

I am 19, exercise regularly and eat healthy, yet my blood pressure is always very high at the doctor. He says this is only because of my anxiety disorder. It has been as high as 168/110 before. He did a physical and CBC, thyroid, glucose, and kidney function test and they all came back normal. Does this rule out secondary hypertension?

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Hi,

Welcome to icliniq.com.

Hypertension at your age is not usual and if it is present, a few things need to be evaluated thoroughly, especially your kidneys and your adrenal glands. A renal function test will not be helpful in this case. An MRI or ultrasound of the kidneys would be required to rule out a possibility of adult polycystic kidney disease.

Also, I would like to know if either of your parents has hypertension or autosomal dominant adult polycystic kidneys.

I suggest 24 hour urinary free catecholamines and metanephrines for a probable tumor of the adrenal gland. Please note that I am not saying that you have either of these but at your age hypertension with anxiety disorder may present with these conditions. So, it is important to rule them out.

Also, do you have headaches? That could help identify the problem.

Let me know so I can help.


Investigations to be done:

1. MRI or ultrasound of kidneys. 2. 24-hour urinary catecholamines and metanephrines.

Differential diagnosis:

Pheochromocytoma

Probable diagnosis:

Polycystic kidney disease.

Regarding follow up:

For more information consult a family physician online.--->https://www.icliniq.com/ask-a-doctor-online/family-physician


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