Approximately 3.5 percent of all children in the United States have high blood pressure, according to the American Academy of Pediatrics (AAP), but the prevalence is likely higher, experts say, because many cases go undetected. (1)
Diagnosing High Blood Pressure in Kids
In 2017, the AAP issued updated guidelines for pediatricians on how to diagnose pediatric hypertension. Unlike measuring blood pressure in adults, there is no definition of normal blood pressure for children based on a simple reading of systolic over diastolic blood pressure. Rather, what’s considered normal varies depending on a child’s age, gender, and height. The new guidelines provide a table for normal blood pressure based only on a child’s gender and age. (2) The American Heart Association (AHA) recommends all children have yearly blood pressure measurements starting at age 3. (3) If your doctor determines your child’s blood pressure reading is high, you will need to bring your child back for a few more readings. Your pediatrician may also ask that your child wear a portable device called an ambulatory blood pressure monitor over a 24-hour period. Blood pressure that is consistently high will lead to a diagnosis of pediatric hypertension. (5) Your pediatrician will also take a full medical history, including information about your child’s diet, physical activity level, home and school activities, and possible stressors. Additional tests, like urine tests, blood tests, and an ultrasound of the kidneys, may be necessary to help determine the cause of high blood pressure in a pediatric patient. (5) Therefore, it’s important for kids to have regular doctor’s visits, where they will be screened for high blood pressure at least once a year beginning at age 3. Occasionally, children with severe hypertension may experience symptoms like headaches, loss of vision, double vision, chest pain, abdominal pain, and breathing problems. (6) Essential hypertension occurs on its own without an underlying health condition. This type of high blood pressure is more common in older children, generally older than age 6. Risk factors that lead to essential hypertension include a genetic predisposition or family history of high blood pressure, being overweight or obese, type 2 diabetes, and high cholesterol or triglycerides. (7) According to AAP, by age 7, more than 50 percent of pediatric hypertension cases are caused by obesity. That number rises to 85 to 95 percent by adolescence. Establishing positive health habits, including a healthy diet that is low in sodium and high in fruits and vegetables, and plenty of physical activity, is essential in the early years of life for warding off high blood pressure and other health problems. (1) Cardiovascular complications associated with pediatric hypertension include thickening (hypertrophy) of the heart, which can progress to heart failure. If high blood pressure persists into adulthood, your child could be at an increased risk of stroke, heart attack, heart failure, and kidney disease. (7) If obesity is the cause, your pediatrician will help you come up with a plan to get your child to lose weight. Limiting salt in your child’s diet will be an important piece of the puzzle. This can be done by restricting the use of table salt and using caution when shopping for packaged foods. Many canned and processed foods contain an excess amount of salt, so read labels carefully before purchasing. Aerobic exercise is also vital for lowering kids’ blood pressure. The AAP recommends 60 minutes of physical activity a day. If lifestyle changes are not enough, your pediatrician may recommend blood pressure-lowering medication. The AAP recommends pediatricians start children on blood-pressure-lowering medication only if lifestyle changes have failed to work or if the child has another health condition, such as diabetes or kidney disease. Follow instructions from your healthcare provider carefully and your child will continue to be monitored to make sure the blood pressure is being controlled. (1)
