What is high blood pressure?
Blood pressure is the measurement of the pressure or force with which blood pushes on the walls of the arteries as the heart pumps blood through the body. High blood pressure means the force is higher than normal levels. High blood pressure is also called hypertension.
How does high blood pressure affect children?
High blood pressure is diagnosed differently in children than in adults because healthy blood pressure levels change as a child grows. High blood pressure in children occurs when a child’s blood pressure is equal to or higher than that of 95 percent of other children of the same age, gender, and height.
Over time, high blood pressure can damage a child’s organs, including the brain, heart and kidneys because the heart and blood vessels are not delivering blood to the organs the way they should.
How common is high blood pressure in children?
Approximately 3.5 percent of children and teenagers aged 18 and under in the United States have high blood pressure. It is possible that the number is much higher than this, as some cases may be undiagnosed.
High blood pressure occurs more often in:
- African-American and Hispanic children
- Teenagers, rather than in younger children
Symptoms and Causes
What causes high blood pressure in children?
High blood pressure is classified based on the cause. The types of high blood pressure are:
- Primary or essential hypertension: High blood pressure with no known cause
- Secondary hypertension: High blood pressure caused by an inherited or underlying condition
In children, causes of secondary hypertension include:
- Being overweight
- Breathing problems during sleep (apnea)
- Heart problems
- Kidney disorders
- Medications, including decongestants and steroids
What are the symptoms of high blood pressure in children?
Most children with high blood pressure have no symptoms. Doctors usually discover it when checking a child’s blood pressure during a routine checkup.
In rare cases, high blood pressure can cause a medical emergency.
What children are at risk for developing high blood pressure?
Children at higher risk for high blood pressure include those who:
- Are African-American
- Are overweight
- Have a family member with the condition
- Have diabetes
- Were born prematurely or had a low birth weight
Diagnosis and Tests
How is high blood pressure in children diagnosed?
High blood pressure in children is diagnosed with a blood pressure reading. Most children should have their blood pressure taken at each well care visit and some other problem based visits.
To check blood pressure, a healthcare provider wraps a cuff called a sphygmomanometer on the patient’s arm and places a stethoscope underneath it. The provider pumps the cuff full of air and then takes the reading as the air leaves the cuff.
The blood pressure reading consists of two separate measurements the provider reads together:
- Systolic blood pressure: The top number in a blood pressure reading, which measures pressure in the blood vessels when the heart pushes blood out to the body.
- Diastolic blood pressure: The bottom number in the reading, which measures pressure in the blood vessels when the heart rests between beats.
The readings are compared with those in the normal range for a child of the same age, weight, and height. High blood pressure is usually diagnosed when the pressure levels are higher than the 95th percentile when measured during several visits. (Doctors take several measurements before making a diagnosis of high blood pressure, because the stress of being in a doctor’s office can cause blood pressure to rise in some people.)
Management and Treatment
How is high blood pressure in children treated?
It is important to diagnose and treat high blood pressure in children early to avoid complications. Treatment for high blood pressure depends on the child and the cause, if known. Sometimes the condition can be managed by treating the underlying disorder that is causing it.
In most cases, doctors first recommend lifestyle changes to treat high blood pressure in children. The doctor may ask you to help your child make these lifestyle changes, including:
- Eating a healthy diet, including plenty of fruits and vegetables
- Increasing physical activity
- Losing weight
- Limiting processed and canned foods to help reduce the amount of salt and sugar your child consumes
If lifestyle changes do not lower your child’s blood pressure, the doctor may refer your child to a specialist or recommend medication to manage the condition. These medications are used to treat high blood pressure in children:
- Angiotensin-converting enzyme (ACE) inhibitors, to relax the blood vessels and make it easier for blood to flow
- Angiotensin II receptor blockers, to block the effects of a chemical in the blood that constricts (narrows) blood vessels
- Calcium channel blockers, to relax blood vessels and increase blood supply to the heart
- Beta blockers, to block the effects of adrenaline and lower the heart rate, which lowers blood pressure
- Diuretics, to rid the body of excess fluids and waste
What are the complications associated with high blood pressure in children?
If it is not treated, high blood pressure can damage a child’s organs, including the brain, heart, and kidneys. Over time, this damage can lead to such complications as:
- Heart attack
- Heart failure
- Kidney failure
- Stroke (a loss of blood flow to the brain)
Outlook / Prognosis
What is the prognosis (outlook) for children who have high blood pressure?
Doctors can treat most cases of high blood pressure in children through lifestyle changes and, in some cases, medication. In some children, high blood pressure becomes a lifelong condition. Children who have high blood pressure are more likely to have hypertension as an adult. These children may need medication for the rest of their lives to avoid complications.
When should I see a healthcare provider about my child’s high blood pressure?
If your child has no risk factors for high blood pressure, the doctor will likely start measuring it at annual checkups, beginning at age 3. If your child does have risk factors, your doctor may start checking blood pressure when the child is an infant. This testing will allow your doctor to check your baby for signs of high blood pressure and treat it right away.
What questions should I ask my doctor about high blood pressure in children?
If your child has high blood pressure, you may want to ask your doctor:
- What caused my child’s high blood pressure?
- How serious is high blood pressure at this age?
- What is the right treatment for my child?
- What can we do at home to lower my child’s blood pressure?