brand logo

Am Fam Physician. 2012;86(5):394

Original Article: High Blood Pressure in Children and Adolescents

Issue Date: April 1, 2012

Available at: https://www.aafp.org/afp/2012/0401/p693.html

to the editor: I read this article with interest. However, the authors did not mention heavy metal poisoning as a possible etiology of elevated blood pressure in children. Elemental and inorganic mercury poisonings have been described as causes of hypertension.1,2 Less common metals, such as arsenic and thallium, can also cause hypertension.3,4 Although lead poisoning is known to cause hypertension in adults, it does not seem to do so in children.5

It is important to identify heavy metal poisoning as an etiology of elevated blood pressure because it is potentially treatable. Heavy metal intoxication can be evaluated with 24-hour urine screening. Treatment depends on the particular metal involved, but identification and removal from the source is paramount. Decisions on chelation should be made in consultation with a regional poison control center or medical toxicologist.

in reply: We appreciate Dr. Thornton's comments on heavy metal poisoning as a possible cause of elevated blood pressure in children. Heavy metal poisoning has been described in case reports as causing hypertension in children, but this is relatively rare and does not need to be included in the standard workup for secondary etiologies of hypertension. If heavy metal intoxication is suspected based on history or physical examination findings, then a 24-hour urine sample should be considered.

Email letter submissions to afplet@aafp.org. Letters should be fewer than 400 words and limited to six references, one table or figure, and three authors. Letters submitted for publication in AFP must not be submitted to any other publication. Letters may be edited to meet style and space requirements.

This series is coordinated by Kenny Lin, MD, MPH, deputy editor.

Continue Reading


More in AFP

More in Pubmed

Copyright © 2012 by the American Academy of Family Physicians.

This content is owned by the AAFP. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP.  See https://www.aafp.org/about/this-site/permissions.html for copyright questions and/or permission requests.