If you want to see the spanish translation click here.
Back in 1998. I was doing my Residence in General Medicine in Santa Clara. Villa Clara. Cuba, it was noon and I was set out to see my last patient. He was a 10-year-old boy brought to the clinic by his mother. He looked like a bit overweight and reported intermittent headache for more than two days. Upon taking medical history, the only positive complain was a frontal headache lasting about an hour with no other accompanying symptom.
At physical examination, there was nothing relevant, in my opinion, to point out. I must confess that I was somewhat bewildered about the cause of the headache. However, I explained to the mother that this pain could be the result of multiple causes while I was ordering a routine checkup. The patient was prescribed pain killers and I advised the mother that if something new raised to go the nearest health center. At the stage, the patient was ready to leave the office I came up with the idea to measure his blood pressure (BP) and to my surprise, he had 140 mmHg of systolic blood pressure with 95 mmHg of diastolic blood pressure. Undoubtedly, that was the cause of the persistent headache. I said to myself: “this patient is hypertensive and he is only 11 years old, what should I do?”
I must confess that the desperation of the mother when I told her son’s BP was visible, and she said: “Doctor, what do we do? It’s just a child, can I give him a captopril at that age?” I have always regard sincerity as a fundamental attribute in the human being and as the first commandment of the Hippocratic Oath is: “Do no harm”; I told the mother “I’ll come back right now,” I crossed the street, went to a phone booth and called to the pediatric hospital and they told me how to proceed.
In Cuba, in the 90s, talking about hypertension in children and adolescents was something totally unusual for the medical community, especially at the level of Primary Health System of Care. For most, hypertension in children and adolescents could exist but mainly because of a kidney disease. Really, the perception on HBP at early ages of life was almost null. Likewise, telling a father or mother that their child was a hypertensive kid might be a very difficult issue since HTN was considered by the general population to be an adult disease. After almost two decades of this, I thank life for having been engaged in the previous story, which “slapped” me about my ignorance.
As a result of the above mentioned, I began to “explore” the exciting world of cardiovascular risk and hypertension from the pediatric age. I do not rule out that facts similar to my story can still occur, although at present it seems unlikely if we take into account the number of books, monographs, specialized scientific journals and events that are carried out on HTA. Even though, the medical community has become more aware of the problem, hypertension continues to grow steadily from childhood and beyond with its deadly consequences looming around as time goes on in life. Why? What are we doing wrong? What future perspectives do we have?
To answer these questions has been created this blog, aimed at the general practitioner and other specialties from the conviction that we can improve what we do, but acting from the autochthonous and with intelligence.
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