The causes of acute severe hypertension vary significantly by age: Infancy: Congenital renal disease, renal vascular disease, bronchopulmonary dysplasia, coarctation of the aorta, renal vein thrombosis Childhood: Renal parenchymal disease, renal vascular disease, endocrine disorders, drug - or toxin-induced hypertension Adolescence: Renal parenchymal disease; primary hypertension sometimes with nonadherence to treatment; use of drugs such as stimulants, anabolic steroids or corticosteroids, certain oral contraceptives, or certain illicit drugs (eg, cocaine, amphetamines) Symptoms and Signs BP is markedly elevated, typically to stage 2 hypertension levels or higher (see table Classification of Blood Pressure in Children).