Your Health

High Blood Pressure in Children

(Hypertension in Children)

Definition

High blood pressure is a blood pressure measurement that is higher than normal. Blood pressure is the force of blood on the blood vessel walls. It is measured as two numbers, for example 120/80 millimeters of mercury (mmHg). These two numbers stand for:
  • Systolic pressure (the higher number)—the pressure inside of the arteries during each heart beat
  • Diastolic pressure (the lower number)—the pressure inside of the arteries in between each heart beat
For adults, 120/80 mmHg is considered a normal reading. Children’s blood pressure readings are lower than adults. Their blood pressure is based on a child’s gender, age, and height. This means that what is considered normal or high blood pressure changes as your child grows.
Organs Impacted by High Blood Pressure
High blood pressure and organs
High blood pressure can affect the body in many ways.
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Causes

Blood pressure can be split into two categories:
  • Essential (or primary)—The cause is not known.
  • Secondary—The cause is related to another condition. This may include kidney disease or heart disease.

Risk Factors

Risk factors can vary depending on the type of high blood pressure, for example:
  • Essential high blood pressure
    • Obesity (one of the most common risk factors)
    • Diet high in salt
    • Family history of high blood pressure
    • African American ethnicity
  • Secondary high blood pressure

Symptoms

High blood pressure usually does not cause any symptoms. In some cases, though, your child may:
  • Have a headache
  • Feel dizzy
  • Have vision problems
  • Feel tired

Diagnosis

Your child’s blood pressure is measured at least once per year after your child turns three years of age. An arm cuff and a special device are used to take the reading. The doctor then uses a chart to find which percentile your child is in. This chart is based on your child’s gender, age, and height.
If a reading suggests high blood pressure, your child’s blood pressure will be measured several more times. The average reading will be used to make the diagnosis. This is done in part to eliminate something called "white coat syndrome." Some children can feel very anxious when seeing the doctor. This can cause a temporary rise in blood pressure.
To find out if your child has an underlying condition, the doctor will ask about your child’s medical history. A physical exam will be done. The doctor may also order tests, such as:
  • Blood tests
  • Urine tests
  • Ultrasounds of the heart or kidneys
  • Sleep study (if high blood pressure is linked to sleep problems)
The doctor may also check for other related conditions (eg, high cholesterol , diabetes, sleep apnea).

Treatment

The doctor will work with you and your child to create a treatment plan. If your child has an underlying condition, this will be treated. Treating the underlying condition can help the high blood pressure return to normal.
Other treatment options focus on making lifestyle changes, such as:
  • Eating a healthy diet . Keep the diet high in fruits and vegetables , and whole grains. You may also need to limit how much salt is in your child’s diet.
  • If your child is overweight, follow a safe weight loss program. Use a program recommended by the doctor or dietitian.
  • Encourage your child to participate in regular physical activity.
If your child’s blood pressure is not improving after trying these lifestyle changes, the doctor may consider prescribing medicine, such as:
  • Angiotensin converting enzyme inhibitors (ACE inhibitors)
  • Angiotensin receptor blockers (ARBs)
  • Beta blockers
  • Calcium channel blockers
  • Diuretics
It is important to properly treat high blood pressure to prevent complications in adulthood, such as:

Prevention

Take these steps to help prevent your child from developing high blood pressure:
  • Encourage your child to eat a healthy diet that is rich in fruits, vegetables, and whole grains.
  • If your child is overweight, talk to the doctor about safe ways for your child reach a healthy weight.
  • Encourage your child to participate in physical activity on a regular basis.
  • Talk to your child about the dangers of smoking.
  • Be a good role model for your child. For example, eat healthy food and participate in family physical activities.
  • Limit the amount of time your child can spends in front of a screen. This includes watching TV, playing video games, or using the computer. Aim for less than two hours in front of a screen per day.

RESOURCES

American Heart Association http://www.americanheart.org/

National Heart, Lung, and Blood Institute http://www.nhlbi.nih.gov/

CANADIAN RESOURCES

Canadian Cardiovascular Society http://www.ccs.ca/home/index%5Fe.aspx/

Heart and Stroke Foundation of Canada http://www.heartandstroke.com/

References

Blood pressure levels for boys by age and height percentiles. National Heart Lung and Blood Institute website. Available at: http://www.nhlbi.nih.gov/guidelines/hypertension/child%5Ftbl.pdf. Accessed June 19, 2012.

High blood pressure in children. American Academy of Pediatrics, Healthy Children.org website. Available at: http://www.healthychildren.org/English/health-issues/conditions/heart/pages/High-Blood-Pressure-in-Children.aspx. Updated January 9, 2012. Accessed June 19, 2012.

High blood pressure in children. American Heart Association website. Available at: http://www.heart.org/HEARTORG/Conditions/HighBloodPressure/UnderstandYourRiskforHighBloodPressure/High-Blood-Pressure-in-Children%5FUCM%5F301868%5FArticle.jsp. Updated April 4, 2012. Accessed June 19, 2012.

Hypertension. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/. Updated July 3, 2012. Accessed July 12, 2012.

Hypertension in children and adolescents: work in progress. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/. Updated June 13, 2012. Accessed June 19, 2012.

Kellicker P, Schub T. Evidence-based care sheet: hypertension in children and adolescents. EBSCO Nursing Reference Center website. Available at: http://www.ebscohost.com/pointOfCare/nrc-about. September 16, 2011. Accessed June 19, 2012.

NHLBI integrated guidelines for pediatric cardiovascular risk reduction. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/. Updated February 28, 2012. Accessed June 19, 2012.

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