A 13-year-old boy visits his pediatrician because his school football team requires
medical clearance before the start of the season. On physical examination, his weight
is 72 kg (above the 99th percentile for age and sex) and his height is 155 cm (the
50th percentile); his body-mass index (the weight in kilograms divided by the
square of the height in meters) is 30 (above the 99th percentile). His blood pressure
is 134/77 mm Hg (the 99th percentile for systolic blood pressure and the 90th percen
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tile for diastolic blood pressure), and his heart rate is 70 beats per minute. The serum
creatinine level is 0.7 mg
per deciliter (62 μmol per liter), and the urinalysis is normal.
He is otherwise healthy and does not report any symptoms. His father has hyperten
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sion and type 2 diabetes. How should this case be further evaluated and treated?