Background. Hypertension in young people is secondary, but stress could be an important risk factor. Case report. A 21 years old patient presented for increased blood pressure in the last two months. He has no medical history, he is non-smoker. Physical exam: normal weight, blood pressure (BP) 160/90 mmHg, 75 bpm, regular. Laboratory tests: mild hypercholesterolemia. Abdominal ultrasound: normal right kidney, left kidney 66/48mm, thin parenchyma. Transthoracic echocardiography, thyroid ultrasonography was in normal limits. Ambulatory blood pressure monitoring showed more than 47% of diurnal values greater than 140 mmHg, with diurnal average blood pressure 137/85 mmHg and nocturnal average blood pressure 115/72 mmHg. Pulse pressure was 42.7 mmHg. Serum TSH, free T4, aldosterone, renin and urinary metanephrines, normetanephrines, 3-methoxytyramine, vanillylmandelic acid was in normal limits. Plasma cortisol was 589 nmol/L. Chest CT in normal limits. Contrast enhanced abdominal CT: normal right kidney, left kidney 70 mm, 5 mm cortical thickness, normal shape, position, secretion and excretion. Angiography showed two left renal veins, one of them over the artery, but with normal caliber of the left renal artery. Conclusions. BP values occurred in conditions of a job with a lot of stress to a young patient with a left kidney malformation, but with normal renal function. Stress is responsible for a lot of physiological changes, including constant increase in blood pressure. The scale of cardiovascular risk should be reevaluated to young people through proper trials.