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by Stahl RJ

High Blood Pressure in Children

(Hypertension in Children)

Definition

Blood pressure is the force of blood on the blood vessel walls. High blood pressure is one that is higher than normal. It is measured as 2 numbers:
  • Top number—the pressure when heart is squeezing
  • Lower number—the pressure the heart is at rest
High blood pressure can cause damage to blood vessels and certain organs. The damage gets worse over time. It can lead to a higher risk of heart and kidney disease or stroke in early adulthood.
Organs that Can Be Injured by High Blood Pressure
High blood pressure and organs
High blood pressure can affect the body in many ways.
Copyright © Nucleus Medical Media, Inc.

Causes

The cause of high blood pressure will depend on type:
  • Essential (or primary)—The cause is not known.
  • Secondary—Another illness is causing the problem.

Risk Factors

Things that may increase the risk of essential high blood are:
  • Obesity
  • Diet high in salt
  • High blood pressure in family
Things that may increase the risk of secondary high blood are:

Symptoms

High blood pressure will often not cause any symptoms. Some children may:
  • Have a headache
  • Feel dizzy
  • Have vision problems
  • Feel tired

Diagnosis

Normal blood pressure in children is different from adults. It will also vary by gender, age, and height. The range of normal blood pressure will change as the child grows.
Blood pressure is measured at least once per year after 3 years of age. A chart will show what a healthy blood pressure range based on child’s gender, age, and height. A high blood pressure needs to happen on more than 1 measurement to be diagnosed. The doctor may also ask that a measurement be done at home. This will rule out normal increased blood pressure due to anxiety at a doctor's office.
Other tests may be done to look for a cause.

Treatment

The treatment plan will be based on the cause. Treating related conditions may return blood pressure to normal.
Steps that may treat essential high blood pressure or manage secondary high blood pressure are:
  • A healthy diet that is high in fruits and vegetables, and whole grains. Salt may also need to be tracked or lowered.
  • Weight loss for children who are overweight. A doctor or dietitian can help to make a safe plan.
  • Regular physical activity. This includes sport, play, and less screen time.
Some blood pressure may not be lowered by above changes. Medicine may then be needed. Types of blood pressure medicine are:
  • Angiotensin converting enzyme inhibitors (ACE inhibitors)
  • Angiotensin receptor blockers (ARBs)
  • Beta blockers
  • Calcium channel blockers
  • Diuretics
It is important to treat high blood pressure. It can prevent serious health issues in adulthood.

Prevention

Healthy habits can help prevent some types of high blood pressure:
  • Encourage a healthy diet. It should be rich in fruits, vegetables, and whole grains.
  • Talk to the doctor about your child's weight. Ask if any steps should be taken.
  • Encourage physical activity.
  • Be a good role model for your child. Eat healthy food. Find physical activity for the whole family to do. This can be as simple as a walk after dinner.
  • Limit the amount of time your child spends in front of a screen. This includes watching TV, video games, or computer use. Aim for less than 2 hours in front of a screen per day.

RESOURCES

American Heart Association
http://www.heart.org
National Heart, Lung, and Blood Institute
http://www.nhlbi.nih.gov

CANADIAN RESOURCES

Canadian Cardiovascular Society
http://www.ccs.ca
Heart and Stroke Foundation of Canada
http://www.heartandstroke.ca

References

Flynn JT, Kaelber DC, Baker-Smith CM, et al; Subcommittee on Screening and Management of High Blood Pressure in Children. Clinical Practice Guideline for Screening and Management of High Blood Pressure in Children and Adolescents. Pediatrics. 2017 Sep;140(3).
Hypertension in children and adolescents. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/hypertension-in-children-and-adolescents/ . Updated June 20, 2018. Accessed December 31, 2019.
National Heart, Lung, and Blood Institute. Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents. NHLBI Oct 2012. Available at: https://www.nhlbi.nih.gov/files/docs/guidelines/peds%5Fguidelines%5Ffull.pdf. Accessed December 31, 2019.
Screening and treating kids for high blood pressure: AAP report explained. Healthy Children—American Academy of Pediatrics website. Available at: http://www.healthychildren.org/English/health-issues/conditions/heart/pages/High-Blood-Pressure-in-Children.aspx. Updated August 21, 2017. Accessed December 31, 2019.

Revision Information

  • Reviewer: EBSCO Medical Review Board Kari Kassir, MD
  • Review Date: 12/2019
  • Update Date: 12/31/2019
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