We usually think of High Blood Pressure—also known as Hypertension—as a problem that affects adults. But, in fact, the condition can be present at any age.
Rates of High Blood Pressure in children and adolescents have increased in the last 20 years in the United States.
An estimated 3.5% of all children and teens in the United States havehigh blood pressure, however, the condition often goes undetected and untreated.
Childhood Hypertension, particularly in pre-adolescents, is more often secondary to an underlying disorder than in adults. Kidney disease is the most common secondary cause of Hypertension in children and adolescents.
Hypertension occurs in around 0.2 to 3% of newborns; however, blood pressure is not measured routinely in healthy newborns. Hypertension is more common in high risk newborns. A variety of factors, such as gestational age, post conceptional age and birth weight needs to be taken into account when deciding if a blood pressure is normal in a newborn.
Blood pressure rises with age in childhood, failure to thrive, seizures, irritability, lack of energy, and difficulty in breathing can be associated with Hypertension in neonates and young infants. In older infants and children, Hypertension can cause headache, unexplained irritability, fatigue, failure to thrive, blurred vision, nosebleeds, and facial paralysis.
In 2004 the National High Blood Pressure Education Program recommended that children aged 3 years and older have blood pressure measurement at least once at every health care visit and the National Heart, Lung, and Blood Institute and American Academy of Pediatrics made a similar recommendation.
High blood pressure in children is almost always asymptomatic—that is, without any symptoms or noticeable discomfort.
In many cases, high blood pressure seems to develop with age. As a result, a child may show no signs of High Blood Pressure as an infant, but may develop the condition as he or she grows.
By age 7, more than 50% of Hypertension is due to obesity; this rises to 85–95% by the teenage years. Thus, good eating habits (without overeating and emphasizing foods low in sodium, low in added sugar and high in fruits and vegetables) and plenty of physical activity are important throughout the early years of childhood (and for the rest of life).
Diagnosing High Blood Pressure in Children If your child’s blood pressure is high, your pediatrician may recommend tests to see if there is an underlying medical problem causing it. These tests include studies of the urine and blood. Sometimes, ultrasounds are used to examine the heart or the kidneys. If no medical problem can be found, your child will be diagnosed with essential Hypertension—the word essential refers only to the fact that no cause could be found.
Management & Treatment
The first-line treatment for high blood pressure in children remains lifestyle changes.
*.If obesity is a possible cause, the first step will be to have your child lose weight. This will need to be very closely monitored by your pediatrician. Not only will weight loss lower blood pressure, it can provide many other health benefits as well.
*.Limit the salt in your child’s diet. Giving up the use of table salt and restricting salty foods can lower blood pressure in some patients. Common sources of salty foods include bread, deli meats, pizza, and foods prepared outside the home.
*.Use caution when shopping for packaged foods. Most canned and processed foods contain a great deal of salt, so check labels carefully to make sure the items have little or no salt added.
*.Help your child get more aerobic exercise. Aerobic physical activity can lower blood pressure, because of its effect on blood vessels and the heart—even when patients do not lose weight. The AAP recommends 60 minutes of physical activity each day.
Once your pediatrician knows your child has high blood pressure, he or she will want to check it frequently to make sure the Hypertension is not becoming more severe. Depending on how high the blood pressure is, your pediatrician may refer your child to a specialist—usually a pediatric nephrologist (kidney specialist) or pediatric cardiologist (heart specialist).