You may think that high blood pressure is a health condition that affects only adults. However, with a growing number of children developing hypertension (high blood pressure), experts have identified more effective ways to screen at-risk children earlier. The American Academy of Pediatrics (AAP) recently released a new set of guidelines to define high blood pressure, to make recognition easier, and to guide treatment so children will have lower risk of high blood pressure complications later in life.
Detecting hypertension in kids
Sarah E. Barlow, M.D., Director of Children’s Health℠ Integrated Program in Childhood Obesity and Professor at UT Southwestern, explains that hypertension is a silent condition. Typically, there aren’t obvious symptoms to let parents know their child has hypertension; it is often diagnosed when the doctor discovers it during an exam.
“It can take decades for problems to appear, including burdens on the heart,” Dr. Barlow says. “That’s why it’s important to screen for and recognize hypertension in children and perform early intervention to avoid later, serious complications.”
Conditions linked to hypertension
Hypertension, if left untreated, can cause serious complications including:
- Arteriosclerosis (hardening of arteries and thickening of heart muscles)
- Coronary artery disease (arteries are narrowed due to plaque buildup)
- Heart attack
- Kidney failure
- Vision loss
Precise guidelines mean better care
According to the AAP, 3.5 percent of all children and adolescents have hypertension. This statistic came from new blood pressure tables that base healthy blood pressure ranges on children with healthy weight.
The AAP adjusted the range to define normal blood pressure measurement for good health, explains Dr. Barlow. Parents can expect that their child’s blood pressure will be checked once a year, at the well child visit, starting at age 3. But the blood pressure will be checked at every visit if the child has a condition that makes hypertension more likely, such as obesity or a kidney problem, or if the blood pressure is high at the well child visit.
What to know before your child’s blood pressure screening
Your child’s blood pressure might be high when it is measured for many reasons, including stress, illness, recent physical activity, a true hypertension issue or medical condition. Your pediatrician tracks trends over time, not just the initial screening, to accurately identify the cause of the reading before making a diagnosis.
A normal or high blood pressure varies by child
Dr. Barlow cautions there isn’t a single number or normal blood pressure for children. The healthy range of blood pressure for each child depends on height and age and gender, and the new guidelines help pediatricians determine what your child’s healthy range should be.
“Your pediatrician is looking at how your child compares to others of the same height, age and gender,” continues Dr. Barlow. “It’s more complicated than before, but much more precise. There isn’t a typical number that indicates high blood pressure.”
Your pediatrician will track blood pressure for at least three visits, unless your child has been previously diagnosed with a condition associated with hypertension. If your pediatrician notices a hypertension trend, blood pressure will be closely monitored and addressed. If not, blood pressure levels will continue to be checked during well visits. After age 13, the blood pressure ranges are the same for teenagers and adults, making it even easier to diagnose and treat hypertension.
Your pediatrician may have your child wear a 24-hour, portable blood pressure monitoring device (worn at home, during normal routine); it takes measurements every 15 to 30 minutes during the daytime and 30 to 60 minutes at night. This monitor can help your pediatrician decide whether your child needs treatment, by giving a complete picture of blood pressure throughout the day and night
Factors that can cause hypertension in children
- Adrenal or thyroid disorders
- Being overweight or obesity
- Genetics (inherited from a parent or grandparent)
- Congenital or Acquired Heart disease
- High-sodium diet (too much salt)
- Kidney disease
- Lack of physical activity
What to know after a diagnosis
If your child is diagnosed with hypertension without an associated condition, your pediatrician may recommend the following lifestyle changes to reduce risk:
- DASH Diet: Designed from research sponsored by the National Institutes of Health, the plan focuses on eating fruits, vegetables, low-fat & nonfat dairy, nuts, beans and seeds.
- Exercise: The AAP recommends children and adolescents get 60 minutes or more of physical activity daily (includes outside play and team sports).
- Low-sodium diet: Sodium is the scientific name for the salt in food. Dr. Barlow says in addition to watching table salt usage, be cautious with how much processed food your child eats; read labels and be aware of hidden sodium.
- Medications: Your child may be put on medication to control his or her blood pressure; the medicines are the same ones adults take, just in age and weight-appropriate doses.
Help your child prevent high blood pressure and complications. Talk about the importance of a healthy lifestyle and continue to be a good role model – making healthy food choices and engaging in exercise as a family.
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