Severe Hypertension in Young Adults with Intracerebral Hemorrhage and Target-Organ Damage: A Two-Case Series from Timor-Leste
Abstract
Background
Hypertension is a major modifiable risk factor for cardiovascular disease, stroke, chronic kidney disease, and premature death. Although hypertension is more common with increasing age, it is increasingly recognized in young adults. Severe hypertension in this age group is particularly concerning because it may reflect previously unrecognized hypertension or secondary hypertension and can result in premature target-organ damage. We report two young men who presented with severe hypertension complicated by intracerebral hemorrhage and neurological disability.
Case Presentation
Case 1: A 24-year-old man with no previously documented medical illness presented after four days of headache, vomiting, and subsequent loss of consciousness. He was a heavy smoker, unemployed, reported poor sleep, and reported no regular exercise. His mother had poorly controlled hypertension. His admission blood pressure was 218/147 mmHg. He had a Glasgow Coma Scale (GCS) score of 12/15, neck stiffness, bilateral proptosis, and right-sided hemiplegia. Investigations showed marked neutrophilic leukocytosis, severe renal dysfunction, hyperuricemia, and elevated total cholesterol. Chest radiography showed cardiomegaly and bilateral basal opacities, electrocardiography showed left ventricular hypertrophy, and brain computed tomography demonstrated a left temporo-occipital intraparenchymal hemorrhage with compression of the ipsilateral ventricle. Echocardiography demonstrated hypertensive heart…
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Evidence Hub reads this as a case series, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
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