High Blood Pressure (Hypertension)

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:

If either or both of these measurements are above the range found in healthy individuals of similar age and sex, it’s called hypertension.

Who gets high blood pressure

Causes

In most instances of high blood pressure, 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. In addition, the stress on blood vessels in the brain can cause them to burst, producing a stroke. 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 found to have hypertension to have their blood pressure checked regularly by their pediatrician, and for you to follow the doctor’s 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:

Diagnosis

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, as in most cases, no causative medical problem can be found, the diagnosis of essential hypertension will be made. (In medical terms, the word essential refers only to the fact that no cause could be found.)

Managing your child's high blood pressure

Medication

Once the 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 kidney expert. 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. Alternatively, or if this doesn’t return your child’s blood pressure to normal, an antihypertensive drug will be prescribed. Initially the doctor will prescribe a single drug, adding others only if the blood pressure is difficult to control.

Follow your pediatrician's instructions

When your child’s blood pressure is brought under control with diet or medication, you may be tempted to let her increase her salt intake or stop taking her medicine because the problem seems to be gone. However, doing this will only bring back the hypertension, so be sure to follow your pediatrician’s instructions exactly.

Early detection is key

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 (infants that were preterm, had a low birth weight, and who had a difficult or prolonged hospital stay, as well as in 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).

Prevention

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.

It’s also wise to keep excess salt out of your child’s diet, even if she doesn’t have high blood pressure. There’s no clear evidence that salt causes this problem, but your child doesn’t need extra salt, and once she develops a taste for it, she’ll have more difficulty decreasing salt intake if she develops blood pressure problems later in life.

 

Published online: 6/07

Source: Caring for Your Baby and Young Child: Birth to Age 5 (Copyright © 2004 American Academy of Pediatrics, Updated 5/05)
To order a copy of this book visit the AAP Bookstore.
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