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Table 8 Guiding criteria for the differential diagnosis between essential hypertension and secondary forms of hypertension

From: Focus on prevention, diagnosis and treatment of hypertension in children and adolescents

  Essential forms Secondary forms
Onset Most frequent in children and adolescents Often early
Discovery Casual during annual control visit Often underlying disease already known
Blood pressure values Moderately elevated Often markedly elevated
Associated symptoms None According to specific disorder
Family history Often positive for essential hypertension Familiar forms are rare
Overweight Often present Not frequent
Femoral pulse Present Reduced or absent with coarctation of the aorta
Difference between BP values in upper and lower extremities Not present Present with coarctation of the aorta
Blood sodium, potassium and creatinine levels, urinalysis, thyroid hormones Normal Altered in some specific disorders
Echocardiography Normal (left ventricular hypertrophy may be present) Allows diagnosis of coarctation of the aorta (left ventricular hypertrophy may be present)