Medication and Substance-Induced Hypertension: Mechanisms and Management

In most instances, childhood hypertension does not have an identifiable cause aside from a clear association with obesity. In a small percentage of cases, a source of the hypertension can be identified. Common secondary causes of hypertension include kidney disease, renovascular disease, varied endocrine disorders, and druginduced hypertension. Prescribed and over-thecounter medications, herbal supplements, and illicit substances have all been linked to hypertension. Hypertension induced by medications, herbal supplements, and illicit drugs should be considered in any child with new-onset hypertension or worsening control of existing hypertension, especially when the rise in blood pressure is abrupt and extreme. Fortunately, blood pressure typically returns to normal values soon after stopping the offending agent, and pharmacologic intervention is usually not required.