Atypical Chest Pain and Hypertension in a Young Woman

Hypertension among young people is fairly common, affecting one quarter of the global population and 1 in 8 adults aged between 20 and 40 years. It is one of the main modifiable risk factors for cardiovascular disease and mortality.

Since many forms of secondary hypertension led to “treatment-resistant” hypertension, it is important to determine the likely causes and this evaluation partly depends on the degree of difficulty in controlling blood pressure.

It is recommended that clinicians should look for the clinical clues that suggest secondary hypertension as it is too expensive and time consuming to perform a complete evaluation for secondary hypertension in every hypertensive patient.

The most common causes of secondary hypertension among young adults are hypothyroidism (1.9%), renovascular disease (1.7%), renal insufficiency (1.5%), primary hyperaldosteronism (1.2%), Cushing syndrome (0.5%), and pheochromocytoma (<0.3%).