Refractory hypertension in an otherwise healthy adolescent

Severe hypertension, for which no cause could be found, developed in an adolescent female. The patient's blood pressure was refractory to intensive pharmacologic intervention. After 11/2 years of medical management, the patient's intra-arterial blood pressures were found to be in the normotensive range. Individuals with labile hypertension may be refractory to pharmacologic control and may require continuous pressure monitoring in order to establish a proper diagnosis.