High Blood Pressure In Children

High blood pressure, also called hypertension, in kids is when their blood pressure is very high compared to other kids of the same age, sex, and height. There's no single number that defines high blood pressure in all children because what's normal changes as they grow. For teens, though, high blood pressure is defined the same way as for adults: a reading of 130/80 millimeters of mercury (mm Hg) or higher.

If a child has high blood pressure and is young, it's more likely there's a specific medical reason for it. Doctors can often find the cause. Older kids may have high blood pressure for similar reasons adults do, such as being overweight, not eating healthy foods, and not getting enough exercise.

Making healthy lifestyle changes, like eating foods lower in salt and getting more physical activity, can help lower a child's blood pressure. But sometimes, medicine is needed to bring blood pressure to a healthy level. A doctor will determine what's best for each child.

High blood pressure often has no noticeable symptoms. However, some signs might signal a serious problem called a hypertensive crisis. These signs can include:

• Headaches: These could be more intense or different than usual headaches.
• Seizures: This means uncontrolled muscle movements or fits.
• Vomiting: Frequent or severe vomiting, especially if accompanied by other symptoms.
• Chest pains: Pain in the chest, similar to angina or heart attack symptoms.
• Fast, pounding, or fluttering heartbeat (palpitations): Noticeably rapid or irregular heartbeats. This might feel like your heart is racing.
• Shortness of breath: Difficulty breathing or feeling like you can't get enough air.

If you or your child are experiencing any of these symptoms, it's crucial to seek immediate medical attention. Don't delay. A hypertensive crisis needs urgent care to prevent serious complications.

Doctors recommend checking a child's blood pressure during regular checkups starting when they are three years old. If a child has high blood pressure, their blood pressure should be checked at every visit.

If a child has a health problem that could make high blood pressure more likely, like being born early, having a low birth weight, a heart problem present at birth, or certain kidney issues, blood pressure checks may start soon after birth. This is because these conditions can increase the chances of high blood pressure later on.

If you're worried your child might be at risk for high blood pressure, such as if they are overweight or obese, talk to their doctor. It's important to discuss any concerns about your child's health with their doctor, so they can help determine if there are any potential risks and what steps to take.

High blood pressure in kids can have different causes. In younger children, high blood pressure often points to another health problem, like a heart or kidney issue, a genetic condition, or a hormonal imbalance. Older children, particularly those who are carrying extra weight, are more likely to have high blood pressure that's not connected to any other health problem. We call this "primary hypertension." It just happens on its own, without any other underlying cause.

A child's chance of having high blood pressure is influenced by a mix of things. Their health, family history, and how they live all play a role.

High blood pressure in children often continues into adulthood if not treated. This means a child with high blood pressure now is more likely to have high blood pressure as an adult. Untreated high blood pressure in adults can lead to serious health problems. These problems include:

• Stroke: A stroke happens when blood flow to the brain is interrupted, potentially causing brain damage.
• Heart attack: A heart attack occurs when blood flow to the heart is blocked, which can damage the heart muscle.
• Heart failure: Heart failure happens when the heart can't pump blood effectively throughout the body, leading to fluid buildup and other problems.
• Kidney disease: High blood pressure can damage the kidneys over time, potentially leading to kidney failure.

It's important for children with high blood pressure to get treatment to help prevent these serious health issues later in life.

Helping kids avoid high blood pressure involves healthy habits. Just like adults, kids can benefit from lifestyle changes to prevent or manage high blood pressure. This means keeping a healthy weight, eating foods with less salt, and getting regular exercise.

Sometimes, high blood pressure is a sign of another health problem. If that's the case, treating or managing the underlying condition can often help control or even prevent the high blood pressure.

The doctor will examine your child and ask about their health history, including any family history of high blood pressure, as well as their diet and activity levels.

The doctor will carefully measure your child's blood pressure. Using the right-sized blood pressure cuff is crucial for accurate readings. The measurement needs to be taken in a quiet room where your child feels relaxed and comfortable. To be sure, the doctor might take your child's blood pressure more than once during a single visit.

A diagnosis of high blood pressure in children requires that their blood pressure be higher than normal during at least three separate doctor visits.

If the doctor finds your child has high blood pressure, they'll need to figure out if it's a primary problem (meaning it's not caused by another health issue) or a secondary problem (meaning it's caused by something else). To find the cause, the doctor might use these tests:

To confirm the diagnosis and understand the cause of the high blood pressure, the doctor may recommend a device that your child wears for a while. This device, called an ambulatory blood pressure monitor, measures your child's blood pressure throughout the day and night, while they are active and while they are sleeping. This helps to identify whether the high blood pressure is a temporary response to stress or anxiety (called "white coat hypertension") or a more persistent problem.

Additional tests that might be used include:

• Blood tests: These tests check the function of the kidneys, the balance of important minerals in the blood (electrolytes), and levels of fats like cholesterol and triglycerides.
• Urine test: This test examines the urine for signs of problems.
• Echocardiogram: This test uses sound waves to create images of the heart and how blood flows through it.
• Ultrasound of the kidneys: This test uses sound waves to create images of the kidneys.

Managing High Blood Pressure in Children

If your child has slightly or moderately high blood pressure (stage 1), a doctor will likely suggest healthy lifestyle changes first. This might include a heart-healthy diet, rich in fruits, vegetables, and whole grains, along with regular physical activity, like playing sports or taking walks. These changes often help lower blood pressure.

If healthy lifestyle changes aren't enough to bring the blood pressure down to a healthy level, the doctor might prescribe medicine.

For severe high blood pressure (stage 2), medicine is usually recommended right away.

The doctor will decide on the best medicine and how long your child needs to take it. The length of time depends on many factors. For example, if your child is overweight or obese, losing weight could help lower their blood pressure enough to stop needing medicine. Treating any other medical conditions your child has could also help control their blood pressure.

While we don't completely know the long-term effects of blood pressure medicine on a child's growth and development, many of these medicines are generally considered safe for children.

Different types of blood pressure medicine work in slightly different ways:

• ACE Inhibitors: These medicines help blood vessels relax by blocking a substance that makes them narrow. This allows blood to flow more easily, lowering blood pressure.

• Angiotensin II Receptor Blockers (ARBs): Similar to ACE inhibitors, these medicines also relax blood vessels by blocking a substance that narrows them.

• Calcium Channel Blockers: These medicines relax the muscles in blood vessels and can also slow down the heart rate, reducing blood pressure.

• Diuretics (water pills): These medicines work in the kidneys to help your child get rid of extra sodium and water. This reduces the amount of fluid in the body, which lowers blood pressure.

It's crucial to follow your doctor's instructions carefully and to discuss any concerns you have about your child's treatment.

Treating high blood pressure in kids is similar to treating it in adults. It often starts with healthy lifestyle changes, and these changes can even make medication more effective if your child needs it.

Lowering Sodium Intake: A big part of managing high blood pressure is reducing salt, or sodium, in your child's diet. Young children (ages 2-3) should have no more than 1,200 milligrams (mg) of sodium each day. Older kids should limit their sodium to 1,500 mg per day.

This means cutting back on processed foods, which are often loaded with hidden salt. It's also important to limit trips to fast-food restaurants, as their meals tend to be high in salt, fat, and calories.

Other Important Lifestyle Changes:

• Healthy Weight: If your child is overweight, reaching or maintaining a healthy weight is crucial for lowering blood pressure. This means paying attention to their overall diet and activity level. Growing taller while maintaining a stable weight is also beneficial.

• Heart-Healthy Eating: Encourage your child to eat foods that are good for their heart. This includes plenty of fruits, vegetables, whole grains, low-fat dairy, and lean proteins like fish and beans. It's also important to limit foods high in fat and sugar.

• Physical Activity: All kids need at least an hour of moderate to vigorous physical activity each day. This could include playing sports, dancing, biking, or any other activity that gets them moving.

• Screen Time Limits: To encourage more physical activity, limit how much time your child spends watching TV, playing video games, or using other electronic devices.

• Family Involvement: It's easier for a child to make healthy choices when the whole family is on board. Set a good example by eating healthy and exercising regularly. Make healthy habits fun by playing games as a family, like biking, playing catch, or going for walks together. This benefits everyone in the family.