What is the most likely diagnosis for a previously healthy 8-year-old with mild hypertension and obesity?

Primary hypertension, also known as essential hypertension, is the most likely diagnosis for a previously healthy 8-year-old who presents with mild hypertension and obesity. This condition has become increasingly recognized in pediatric populations, largely due to rising rates of childhood obesity, which is a significant risk factor. In children, primary hypertension is usually characterized by an increase in blood pressure without an identifiable secondary cause.

Given that the child is previously healthy and does not show indications of underlying medical conditions typically associated with secondary hypertension (like renal disease, endocrine disorders, or structural problems), it supports the likelihood that the hypertension is primary. Furthermore, the combination of obesity and mild elevation in blood pressure aligns with trends observed in pediatric patients, emphasizing how lifestyle factors can contribute significantly to hypertension risk.

Other considerations, such as hypertension due to renal issues or stress-related hypertension, usually require specific clinical signs or histories, which do not appear to be present in this scenario. Thus, the context of the patient’s health history combined with current understanding of pediatric hypertension aligns well with primary hypertension as the most probable diagnosis.