High blood pressure in children

Description

High blood pressure (hypertension) in children is the pressure of the blood that is at or above the 95th percentile for children of the same sex, age and height of your child. There is not a simple target range for the high blood pressure in all children, because what is normal changes as children grow. However, in adolescents, the high blood pressure is defined the same as for adults: A blood pressure reading greater than or equal to 130/80 millimeters of mercury (mm of Hg).

The younger the child, the more likely it is that high blood pressure is caused by a specific and identifiable medical condition. Older children may develop high blood pressure for the same reasons that adults — excess weight, poor diet and lack of exercise.

Lifestyle changes, such as eating a heart-healthy diet low in salt (sodium), and do more exercise, can help reduce high blood pressure in children. But for some children, medication may be necessary.

Symptoms

High blood pressure usually does not cause symptoms. However, the signs and symptoms that may indicate high blood pressure emergency (hypertensive crisis), which include:

  • Headaches
  • Seizures
  • Vomiting
  • Pains in the chest
  • Fast, pounding, or fluttering heartbeat (palpitations)
  • Shortness of breath

If your child has any of these signs or symptoms, seek emergency medical attention.

When to see a doctor

Your child's blood pressure should be checked during routine well check appointments from 3 years old of age, and at each appointment with the doctor if your child has high blood pressure.

If your child has a condition that may increase the risk of high blood pressure — including premature birth, low birth weight, congenital heart disease and certain kidney problems — blood pressure control may begin soon after birth.

If you are concerned about your child having a risk factor for high blood pressure, such as having obesity, talk with your child's doctor.

Causes

High blood pressure in young children is often related to other health conditions, such as heart defects, kidney disease, genetic disorders or hormonal disorders. Older children, especially those who are overweight are more likely to have primary hypertension. This type of high blood pressure occurs on its own, without an underlying condition.

Risk factors

His son of the risk factors for high blood pressure depend on the conditions of health, genetics and lifestyle factors.

Primary (essential) hypertension

Primary hypertension is caused by their own account, without an identifiable cause. This type of high blood pressure occurs more often in children 6 years of age and older. The risk factors for the development of primary hypertension include:

  • Being overweight or having obesity
  • Having a family history of high blood pressure
  • Type 2 diabetes or a high level of sugar in the blood on an empty stomach
  • Having high cholesterol
  • Eating too much salt
  • To be Black or Hispanic
  • The fact of being a man
  • Smoking or exposure to second-hand smoke
  • Being sedentary

Secondary hypertension

Secondary hypertension is caused by another condition. It is most common in young children. Other causes of high blood pressure include:

  • Chronic kidney disease
  • Polycystic kidney disease
  • Heart problems, such as severe narrowing (coarctation) of the aorta
  • Adrenal disorders
  • Overactive thyroid (hyperthyroidism)
  • The narrowing of the kidney arteries (renal artery stenosis)
  • Sleep disorders, especially obstructive sleep apnea
  • Certain medications, such as those used to relieve a stuffy nose (nasal decongestant), stimulants used to treat attention-deficit/hyperactivity disorder (ADHD), the caffeine, the nonsteroidal anti-inflammatory drugs (Nsaids) and steroids
  • Cocaine, methamphetamine and similar drugs

Complications

Children who have high blood pressure, is likely to continue to have high blood pressure, as well as adults, at least the start of the treatment.

If your child is high blood pressure continues into adulthood, your child may be at risk of:

  • Stroke
  • Heart attack
  • Heart failure
  • Kidney disease

Prevention

High blood pressure can be prevented in children by making the same lifestyle changes that can help with the treatment of weight-control of your child, providing a healthy diet low in sodium (salt) and encourage your child to exercise.

High blood pressure is caused by another condition can sometimes be controlled or even prevented, by the management of the condition that is causing it.

High blood pressure in children

Diagnosis

The doctor will perform a physical exam and ask questions about your child's medical history, family history of high blood pressure, and nutrition and the level of activity.

Your child's blood pressure will be measured. The correct blood pressure cuff size is important to measure accurately. It is also important that the blood pressure is measured with the right technique, in a quiet environment, with the child resting comfortably. During one visit, her son, the blood pressure can be measured two or more times for accuracy.

For a diagnosis of high blood pressure, your child's blood pressure should be higher than normal when measured during at least three visits to the doctor.

If your child is diagnosed with high blood pressure, it is important to determine whether it is primary or secondary. These tests may be used to search another condition that could be the cause of your child's high blood pressure:

  • Blood tests to check your child's kidney function, electrolytes, and levels of cholesterol and triglycerides (lipids)
  • Sample urine test (urinalysis)
  • Echocardiogram to create images of the heart and the flow of blood through the heart
  • Ultrasound of your child's kidneys (renal ultrasound)

Ambulatory monitoring

To confirm a diagnosis of high blood pressure, your child's doctor may recommend ambulatory monitoring. This means your child temporarily wearing a device that measures the blood pressure during the day, even during sleep, and various activities.

Ambulatory monitoring can help to rule out the blood pressure temporarily due to which your child is nervous at the doctor's office (white coat hypertension).

Treatment

If your child is diagnosed with a little-or moderately high blood pressure (stage 1 hypertension), your child's doctor is likely to suggest trying to lifestyle changes, such as a heart-healthy diet and exercising more, before prescribing medications.

If lifestyle changes do not help, your child's doctor may recommend a blood pressure medication.

If your child is diagnosed with very high blood pressure (stage 2 hypertension), your child's doctor will likely recommend blood pressure medications.

Medications may include:

  • Angiotensin-converting enzyme (ACE) inhibitors. These medications help relax your child's blood vessels by blocking the formation of a natural chemical that narrows blood vessels. This makes it easier for your child to the flow of the blood, reducing the blood pressure.
  • Angiotensin II receptor blockers. These medications help relax blood vessels by blocking a natural chemical that is close to your child in the blood vessels.
  • Calcium channel blockers. These drugs help relax the muscles of your child in the blood vessels and can slow down your heart rate.
  • Diuretics. Also known as water pills, these act on the kidneys of your child to help your child eliminate sodium and water, reducing blood pressure.

Your doctor will tell you how long your child will need to stay on the medication. If your child has high blood pressure is caused by obesity, losing weight can make the medication unnecessary. The treatment of other medical conditions your child has can also control your blood pressure.

Although little is known about the long-term effects of blood pressure medication in a child's growth and development, many of these medications are generally considered safe to take during childhood.

Self-care

High blood pressure is treated similarly in children and adults, usually beginning with lifestyle changes. Even if your child takes medication for high blood pressure, lifestyle changes may make the medication work better.

  • Control your child's weight. If your child is overweight, achieving a healthy weight or to maintain the same weight, while getting higher can reduce the blood pressure.
  • Give your child a healthy diet. Encourage your child to eat a heart-healthy diet with emphasis on fruits, vegetables, whole grains, low-fat dairy products and lean sources of protein, such as fish and beans, and limit the consumption of fat and sugar.
  • Decrease the salt in the diet of your child.The decrease of the amount of sodium (salt) in your child's diet will help to lower your blood pressure. Children from 2 to 3 should not have more than 1,200 milligrams (mg) of sodium per day, and older children should not have any more than 1,500 milligrams (mg) per day. Limit processed foods, which are often high in sodium, and the limit of eating at fast-food restaurants, whose menu items are full of salt, fat and calories.
  • Encourage physical activity. All children should get 60 minutes of moderate to vigorous physical activity per day.
  • Limit screen time. Encourage your child to be more active, to limit the time in front of the television, computer or other devices.
  • Get the family involved. It can be difficult for your child to make lifestyle changes healthy if other members of the family do not eat right or exercise. A good example. Your whole family will benefit from eating better. Create fun family playing together. — ride a bike, play ball or take a walk.

Decrease the salt in the diet of your child. The decrease of the amount of sodium (salt) in your child's diet will help to lower your blood pressure. Children from 2 to 3 should not have more than 1,200 milligrams (mg) of sodium per day, and older children should not have any more than 1,500 milligrams (mg) per day.

Limit processed foods, which are often high in sodium, and the limit of eating at fast-food restaurants, whose menu items are full of salt, fat and calories.

Preparing for your appointment

Your child's blood pressure will be checked as part of a routine physical examination or during any pediatric appointment with the doctor when indicated. Before a control of blood pressure, make sure that your child has not had caffeine or other simulant.

What you can do

Make a list of:

  • The symptoms of his son, and when they began. High blood pressure rarely causes symptoms, but it is a risk factor for heart disease and other childhood illnesses.
  • Key personal information, including a family history of high blood pressure, high cholesterol, heart disease, stroke or diabetes.
  • All medications, vitamins or supplements your child takes, including doses.
  • Your child's diet and exercise habits, including the intake of salt.
  • Questions to ask your doctor.

For high blood pressure, questions to ask your doctor include:

  • What tests will my child need?
  • Does my child need medication?
  • What foods you should eat or avoid?
  • What is an appropriate level of physical activity?
  • How often do I need to schedule appointments to check my child's blood pressure?
  • Should I monitor my child's blood pressure at home?
  • Should my child see a specialist?
  • Can you give Me brochures or other printed material? What sites do you recommend?

Do not hesitate to ask other questions.

What to expect from your doctor

Your child's doctor is likely to ask you questions, such as:

  • When was your child's blood pressure last review? What was the measurement of the blood pressure, then?
  • Was your child premature or of low birth weight?
  • Does your child or anyone in your family smoke?
Symptoms and treatment of high blood pressure in children