Can children get high blood pressure?
We usually think of high blood pressure, or hypertension, as a problem that affects adults. But, in fact, this condition can be present at any age, even in infancy. About five of every hundred children have higher than normal blood pressure, although fewer than one in a hundred has medically significant hypertension.
How blood pressure is measured
The term blood pressure actually refers to two separate measurements:
systolic blood pressure is the highest pressure reached in the arteries as the heart pumps blood out for circulation through the body
diastolic blood pressure is the much lower pressure that occurs in the arteries when the heart relaxes to take blood in between beats
If either or both of these measurements are above the range found in healthy people of the same age and sex, it’s called hypertension.
In many cases, hypertension seems to develop with age. As a result, your child may show no signs of high blood pressure as an infant, but may develop the condition as she grows. Children who are overweight are much more prone to have hypertension (as well as other health problems). Thus, good eating habits (without overeating and without emphasizing high-fat foods) and plenty of physical activity are important throughout the early years of childhood (and for the rest of her life).
In most instances of high blood pressure, other than those cases caused by obesity, no known cause can be identified. However, when hypertension becomes severe in children, it’s usually a symptom of another serious problem, such as kidney disease or abnormalities of the heart or of the nervous or endocrine (gland) system.
Detection is key
Fortunately, high blood pressure alone rarely causes serious problems in children, and can be controlled through dietary changes, medication, or a combination of the two.
However, if hypertension is allowed to continue or become worse over many years, the prolonged extra pressure can lead to heart failure or stroke in adulthood. Also, long-term hypertension causes changes in blood vessel walls that may result in damage to the kidneys, eyes, and other organs. For these reasons it’s important for children with hypertension to have their blood pressure checked regularly by their pediatrician, and for you to follow the doctor’s treatment advice carefully.
Signs and symptoms
In most routine physical examinations, your child's blood pressure will be measured. This is how hypertension is usually discovered. Most often this condition causes no noticeable discomfort, but any of the following may indicate high blood pressure:
Shortness of breath
If your child is found to have high blood pressure, your pediatrician will order tests to see if there is an underlying medical problem causing it. These tests include studies of the urine and blood. Sometimes special X-rays are used to examine the blood supply to the kidneys. If no medical problem can be found, your child will be diagnosised with essential hypertension. (In medical terms, the word essential refers only to the fact that no cause could be found.)
Managing your child's high blood pressure
What will the doctor tell you to do? If obesity is the cause, the first step will be to have your child lose weight. Not only will weight loss lower blood pressure, it can provide many other health benefits as well. The next step toward reducing our child’s blood pressure is to limit the salt in her diet. Giving up the use of table salt and restricting salty foods can reverse mild hypertension and will help lower more serious blood pressure levels. You’ll also have to be cautious when shopping for packaged foods; most canned and processed foods contain a great deal of salt, so check labels carefully to make sure the items have little or no salt added. Your pediatrician also may suggest that your child get more exercise. Physical activity seems to help regulate blood pressure and thus can reduce mild hypertension.
Once your pediatrician knows your child has high blood pressure, he’ll want to check it frequently to make sure the hypertension is not becoming more severe. Depending on how high the blood pressure is, the pediatrician may refer the child to a child hypertension specialist, usually a pediatric nephrologist (kidney specialist) or pediatric cardiologist (heart specialist). If it does become worse, it may be treated with medication as well as diet and exercise.
Many types of medications are available, which work through different parts of the body. At first the pediatrician may prescribe a diuretic, a medicine that increases urine output of salt (sodium), before trying stronger drugs. Or, if this doesn’t return your child’s blood pressure to normal, an antihypertensive drug will be prescribed. When your child’s blood pressure is brought under control with diet or medication it is important to continue the treatment according to your doctor’s recommendations, including changes in diet, or the hypertension will return.
It’s very important to detect hypertension early. It is now recommended that all children have their blood pressure checked beginning at age three, sooner for those at high risk. These include infants who were preterm, or of low birth weight, who had a difficult or prolonged hospital stay. It also includes children who have congenital heart disease, who are receiving medications that might increase blood pressure, or who have any other condition that might lead to high blood pressure.
Because overweight children are more likely to develop hypertension (as well as other health problems), watch your child’s caloric intake and make sure she gets plenty of exercise. Even relatively small decreases in weight or small increases in physical activity may prevent hypertension in overweight children.