DEAR DR. GOTT: My 17-year-old son takes lisinopril for high blood pressure. Lately when he runs around 1 1/2 miles with his soccer team at practice, he has had a difficult time keeping up. He has been finishing about 25 feet behind the group and is usually out of breath. On one occasion he threw up. What makes this unusual is that he has run cross-country or track (a one- and two-mile run) for the last six years. He was the best runner on the soccer team. Does the lisinopril have any effect on his running?
DEAR READER: In teens up to the age of 18, hypertension is defined as a reading greater than the 95th percentile for their age, height and gender. Measurements between 90 percent and 95 percent of that expected range are considered to be borderline, and individuals will run a higher risk of developing high blood pressure as adults.
The prevalence of hypertension in children and adolescents is increasing, due in part to childhood obesity and a growing awareness of the disorder. The presence of hypertension may contribute to the early development of coronary artery disease in adults. Some common causes for teens to develop the condition include hormonal disorders, kidney problems and abnormalities of the aorta. The condition may also be inherited from one or both parents.
Other causes include obesity, drinking alcohol or drug use, renal vascular disease, iatrogenic illness, endocrine causes including hyperthyroidism, the use of dietary supplements and over-the-counter preparations, and a sleep disorder than can increase blood pressure readings.
Lisinopril carries side effects of stomach pain with or without nausea or vomiting, an irregular or slowed heartbeat, chest tightness, chest pain, muscle weakness, lightheadedness and, less common but possible, shortness of breath.
I recommend that he see his prescribing physician to discuss the matter. I certainly cannot say that the medication is solely to blame; in fact, it may have no bearing at all. However, he is young and shouldn’t be experiencing such a rapid decline in his abilities. If his physician feels there is a connection, a simple change to a different drug might resolve the problem.
Further testing may be in order. That might allow him to get back in the game in more ways than one.
Readers who would like related information can send for my Health Report “Hypertension” by sending a self-addressed, stamped No. 10 envelope and a $2 U.S. check or money order to Dr. Peter Gott, P.O. Box 433, Lakeville, CT 06039. Be sure to mention the title, or print an order form from my website’s direct link: www.AskDrGottMD.com/order_form.pdf.
