High Blood Pressure in Children

High blood pressure in children (pediatric hypertension) happens most often in kids ages 12-19. Having it means blood is moving too forcefully through their arteries. It’s important to keep a close eye on this condition if your child has it. This condition can increase their risk of heart disease, kidney damage or even a stroke later in life.

But high blood pressure can be sly — and not always show up with warning signs. You may learn your child has it during a routine checkup. Or they may have frequent headaches, chest pain, dizziness or shortness of breath.

There are two main types of high blood pressure in children. Primary hypertension doesn’t have a distinct cause. Secondary hypertension starts from other health conditions. Kidney disease, congenital heart conditions or hormone imbalances can trigger it.

High blood pressure in children can be silent and has many causes. So, you’ll want to work with pediatric providers experienced in discovering why it’s happening. And who take the best steps to treat it.

What to expect at your child’s first visit

When you come to your child’s first visit, you’ll help tell your child’s story. Understanding what’s been going on is important for our team to make a diagnosis and plan treatment. So, don’t be surprised if your child’s provider asks things like:

• How did you learn your child may have high blood pressure?
• What, if any, symptoms has your child experienced?
• How long have they had these symptoms?
• How active is your child?
• What are your child’s eating habits?
• Has your child been diagnosed with other health conditions?
• Is there a family history of high blood pressure?

During the appointment, your child’s provider will do a physical exam, listen to their heart and measure their blood pressure. Their provider will take several measurements. They may also order other tests before confirming a high blood pressure diagnosis. Your child may have:

• 24-hour ambulatory blood pressure monitoring (ABPM) to confirm the diagnosis of hypertension and rule out “white coat” hypertension
• Blood tests to check hormone levels and how well your child’s kidneys and metabolism
• Urine tests to look for early signs of kidney damage from hypertension
• Electrocardiogram (EKG) to see how their heart is working
• Heart and kidney ultrasounds

Meet Our High Blood Pressure in Children Team

There are many different reasons why your child may have high blood pressure. We keep this in mind as we build their care team with providers from different specialties, like:

• Pediatricians
• Pediatric nephrologists
• Pediatric cardiologists
• Pediatric dietitians
• Pediatric nurse practitioners
• Child life specialists

Your child’s treatment plan centers around their diagnosis and needs. In most cases, their provider will recommend lifestyle changes. Your child may also need to take medications to manage their blood pressure.

Lifestyle changes

A big part of treating high blood pressure in children focuses on lifestyle factors and preventing further problems. Your child’s provider may recommend a heart-healthy diet, more physical activity and managing stress.

And if your child has overweight or obesity, our team can help them reach and maintain a weight that’s healthy for them. Even getting quality sleep plays a role in healthy blood pressure readings.

Medications

If your child needs to take blood pressure medication, they may take:

• ACE inhibitors
• Angiotensin II receptor blockers (ARBs)
• Calcium channel blockers
• Beta-blockers
• Diuretics

Their provider will prescribe what they feel is best for your child. They’ll likely start your child on the lowest possible dose. And they’ll check in with them regularly to make sure the medication is working. Their provider will also adjust the dosage or type of drugs if your child does experience side effects.

Taking the Next Step

It may be hard to wrap your head around the fact that your tween or teen has high blood pressure. It’s just not something you think about happening. But high blood pressure in children isn’t as uncommon as you think. The good news is that it’s treatable. And the expert providers at Cleveland Clinic Children’s are here to guide your child (and your family) through diagnosis and treatment.