Pediatric High Blood Pressure (Hypertension)
When the heart beats, it contracts to push blood into the arteries and then relaxes and refills with blood. Blood pressure is a measure of the force of the blood against the walls of the artery during the heartbeat. Blood pressure measurements provide information about the health of the arteries and indicate how hard the heart is working.
Hypertension or high blood pressure can affect anyone, even infants, and about five out of every 100 children has higher-than-normal blood pressure (those above the 95th percentile).
Blood pressure is measured as systolic (the highest pressure reached in the arteries as the heart pumps blood to circulate through the body) over diastolic (the lower pressure that occurs in the arteries when the heart takes in blood between beats). If either, or both, of these levels is high, a patient has high blood pressure.
Normal blood pressure ranges vary based on your child’s gender, age and height. Children who are overweight or obese have a greater chance of developing high blood pressure and an increased likelihood of developing further health issues from this elevated blood pressure.
Usually, when a younger child has hypertension, the cause is kidney disease or some other problem that affect the child’s blood pressure. Causes usually include:
- Heart defects
- Kidney disease
- Having been born prematurely
- Certain genetic conditions
- Hormonal disorders
When high blood pressure has no known disease-related cause, it’s considered primary hypertension. Less common in children, primary hypertension accounts for most high blood pressure in adults and teens.
- High cholesterol and triglyceride levels
- Family history of high blood pressure
- Type 2 diabetes or high fasting blood sugar levels
- Being overweight or obese (having a body mass index higher than 25)
- Being inactive
- African-American children are at greater risk from age twelve and beyond
High blood pressure usually doesn't have noticeable symptoms. The only way to know whether a child has high blood pressure is to get it checked regularly.
Your child’s doctor will monitor his or her blood pressure at routine physical exams and will take note of any elevation. If your child complains of frequent headaches, dizziness, shortness of breath, visual disturbances or fatigue, you should schedule an appointment with the doctor so his or her blood pressure can be tested.
If the doctor determines that your child has hypertension, the doctor might order additional tests to find out what is causing the high blood pressures. These tests might include:
- Blood tests to assess blood sugar levels and blood cell counts
- Urine tests
- An ultrasound of the kidneys—an ultrasound uses high-frequency sound waves and echoes to create images of organs and structures in the body. It provides the doctor with information about the size and shape of the kidney and helps detect cysts, kidney stones, masses and other problems with your child’s kidney. The test is painless and noninvasive.
- If the doctor thinks your child might have a heart problem, she might order an echocardiogram, a test that uses sound waves to create a detailed, moving picture of the heart.
Since obesity is a major contributor to hypertension in older children and teens, your child’s doctor might recommend efforts to control your child’s weight through diet and increased physical activity. You might receive education on nutrition and diet choices that emphasize fruits, vegetables, whole grains, and other heart-healthy foods that are low in fat, salt, and cholesterol.
Children or teens who have high levels of stress may need help developing relaxation skills and learning to cope with problems. Yoga, meditation, and relaxation training may be helpful.
Smoking also contributes to hypertension. Children or adolescents who smoke may need education and guidance in smoking cessation.
If your child needs medication, your child’s doctor will discuss the choices with you. In most cases, lifestyle changes will control the hypertension without the need for medication.
Follow your doctor’s recommendations for a healthy diet and exercise, and try to make these family habits. And, make sure your child’s blood pressure is monitored regularly, as recommended by the doctor.