Hypertension in children: causes, management and outlook

While hypertension is a condition that primarily affects adults, high blood pressure is increasingly common in children and adolescents. The causes can range from certain health conditions or taking certain medications to other factors, such as family history, age, weight, etc.

Since hypertension not often cause noticeable symptoms, it is important to have your child’s blood pressure checked at least once a year during their annual physical examination.

Keep reading to learn more about the causes of high blood pressure in children, how to treat it, and steps you can take to prevent high blood pressure.

The Centers for Disease Control and Prevention (CDC) shares that about 1 in 25 children in the United States – about 1.3 million – between the ages of 12 and 19 have high blood pressure. This number increases to 1 in 10 if you include high blood pressure, previously called prehypertension. Children in this age group tend to have high blood pressure due to lifestyle factors, such as diet and physical activity.

Other researchers estimate that between 4.7 and 19.4% of children have high blood pressure. This number depends on the sex, race, body mass index, genetic predisposition and other factors of the child. For example, studies show that 20 percent obese children may suffer from hypertension.

Pediatric hypertension statistics can change over time, as the clinical definition of hypertension has evolved over the years. Researchers agree, however, that childhood obesity rates are closely related to childhood hypertension rates in the United States.

The clinical definition of hypertension in children varied depending on the age, size and sex of the child. For your child to be diagnosed with hypertension, their blood pressure must be greater than or equal to the 95th percentile of children of the same age, height, and gender. Not only that, but the reading must hit that mark on three separate office visits.

Adolescents 13 years and older share the same diagnostic criteria as adults. Thus, in this group, blood pressure readings must be 130/80 mm Hg or higher to be diagnosed.

Note: The first (or highest) number is the systolic pressure, or the pressure inside the walls of the arteries when the heart beats. The second number (or lower) is the diastolic pressure, or the pressure inside the walls of the arteries between heartbeats.

There are two types of hypertension in children.

Primary MV is increasingly common in children, but it is even more likely to affect adolescents and adults. This is often due to lifestyle or genetic factors. Older and heavier children are more likely have primary hypertension.

Risk factors for primary hypertension in children include:

There are evidence that black children and teens (especially boys) are at higher risk for hypertension, as are black adults.

Your child will need further evaluation to determine the cause of the high blood pressure. This may include a visit to a cardiologist for an electrocardiogram (ECG) or echocardiogram. They may also require tests like a urine test or blood tests to check kidney function.

Secondary hypertension is more common in children than in adults. In these cases, underlying health conditions or certain medications raise your child’s blood pressure.

Associated conditions include:

Medications or medications that may contribute to high blood pressure include:

Untreated high blood pressure can lead to various health complications as your child grows. The CDC explains that any cardiovascular disease that begins in childhood may be more likely to continue into adulthood.

Complications in adults include:

High blood pressure does not always produce signs or symptoms. In fact, experts say it’s rare to have symptoms of high blood pressure. Some sources even give hypertension the nickname “silent killer” Therefore.

That said, when blood pressure is very high (hypertensive crisis), your child may experience one of the following symptoms:

  • headache
  • seizures
  • visual problems
  • nausea or vomiting
  • chest tightness or pain
  • Heart palpitations

When is it an emergency?

A hypertensive crisis is a medical emergency. If your child has these symptoms, it is important to get medical attention as soon as possible.

The goal of treating hypertension is to get the child’s blood pressure below the 90th percentile for age, height, and sex. For adolescents, the goal is to get blood pressure below 130/80 mm Hg.

To treat primary hypertension, your child’s pediatrician may first recommend lifestyle changes over 3 to 6 months. They may suggest:

  • weightloss
  • regular exercise
  • a healthy diet
  • lower sodium intake

Blood pressure medications are another option your pediatrician may suggest if lifestyle changes aren’t enough to lower your child’s blood pressure. Options include:

  • angiotensin converting enzyme (ACE) inhibitors
  • angiotensin receptor blockers
  • calcium channel blockers
  • thiazide diuretics

These drugs are considered safe for children.

Experts share that there is no consensus on the exact drug to start with when treating high blood pressure in children. Instead, doctors choose on a case-by-case basis. Your child’s pediatrician will usually start with the lowest possible dose and increase it every 2 to 4 weeks if needed.

Treatment of secondary hypertension may require further evaluation and treatment by specialists.

You can’t always prevent high blood pressure. Some cases are the result of underlying health conditions or medication use. If your child has risk factors for health problems that cause hypertension, be sure to talk with your doctor about monitoring your child’s blood pressure to detect problems as early as possible.

In cases where high blood pressure is due to obesity, diet, or inactivity, the following lifestyle measures may help:

  • Eat a balanced diet. The CDC recommends a diet with plenty of fresh fruits and vegetables and less excess sugar and fat. Reducing sodium intake can also help, but talk with a doctor about the appropriate salt intake for your child based on their age and weight.
  • Practice a physical activity. Activities like walking, running, biking, and sports help kids move every day. The amount of exercise to get is based on age. In general, children between the ages of 6 and 17 should aim at least an hour of active time each day.
  • Maintain a moderate weight. Talk to your child’s doctor if you have any concerns about your child’s weight. Your doctor can help you create a plan to help your child achieve a weight within the recommended range for their age, size and sex.

If you have any questions or concerns about your child’s blood pressure, consider writing them down and bringing them to your next appointment.

How often should I check my child’s blood pressure?

The American Heart Association recommends checking your child’s blood pressure every year from 3 years. This can happen during their annual physical exam. Some doctors may take your child’s blood pressure at each visit.

You can also talk to your pediatrician about having your child’s blood pressure checked more frequently if needed. You may want this if your child has an underlying medical condition, takes certain medications, or has other risk factors.

If you take your child’s blood pressure at home, it is important to use the correct size cuff. An ill-fitting cuff can distort the results.

Is high blood pressure hereditary?

Yes. Hypertension can be an inherited condition, which means it can run in families. When this is the case, doctors speak of familial hypertension. Beyond that, the CDC suggests that people in the same household are more likely to develop hypertension due to shared lifestyle factors, such as diet, physical activity and sleep patterns.

Why should my child see a nephrologist if he has high blood pressure?

High blood pressure affects the kidneys. Also, high blood pressure is a common symptom in children with chronic kidney disease.

Over time, high blood pressure can affect kidney function, making it difficult to pass body fluids and waste products. This can create a cycle increased blood pressure and further reduction in kidney function.

If your child’s blood pressure is high, a pediatrician may suggest making an appointment with a kidney specialist (nephrologist) for further evaluation.

Hypertension is a medical condition that is increasingly affecting children in the United States. High blood pressure may have no symptoms, so it is important to have a annual screening during your child’s health check-up. You may want to measure their blood pressure more regularly if your child has additional risk factors.

With prompt treatment and lifestyle changes, you can help your child avoid other health problems associated with high blood pressure as they grow.

About Terry Gongora

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