Hypertension
Also known as: High blood pressure
What is it?
Hypertension is high blood pressure. Blood
pressure is a measure of the force your heart uses
to pump blood throughout the body and the ability
of your blood vessels to deal with that force.
Measuring your child's blood pressure is a routine
part of his/her normal physical examination and
should be performed on every child over two years
of age and in younger children if there are
specific reasons to consider high blood pressure.
Your child’s doctor understands that smaller size
blood pressure cuffs are needed to measure blood
pressure accurately in young children and that the
normal values for children are lower than for
adults.
Who gets it?
About 1% of younger children have high blood
pressure. This percentage increases as children
get older so that hypertension is present in less
than 1% of younger children but significantly more
than that in adolescents. Children who have kidney
problems, who are overweight or who have a family
history of high blood pressure are more likely to
develop high blood pressure. African-Americans
seems to have a higher likelihood of getting high
blood pressure than Caucasians. One group of
children that seem to be at higher risk are
premature infants who require prolonged medical
care in neonatal intensive care units. These
children often require multiple treatments to help
them survive and some develop high blood pressure
as a result of their other neonatal problems.
What causes it?
High blood pressure can have many causes. In
younger children, the most common causes are
related to kidney problems. Sometimes, it is the
finding of the high blood pressure that alerts
doctors to discover the kidney problem. In a small
percentage of cases they are related a narrowing
of the body’s largest blood vessel, the aorta and
in about 1% of cases, there is a hormonal cause.
In at least ½ of he adolescents with high blood
pressure we can’t find a specific cause and we
label it “essential hypertension.” Scientists are
still working to understand the causes of
essential hypertension but we do know that obesity
and high salt intakes are associated with
hypertension.
What are the symptoms?
Most children with high blood pressure are free
of any symptoms. Unfortunately, high blood
pressure can be present for many years, causing
long-term damage to your body without any symptoms
at all. That’s why hypertension has been called
the “silent killer.” When the blood pressure gets
to be very high, younger children may begin to act
strangely, lose their appetite and not gain
weight. Older children may complain of severe
headaches. Rarely, very high blood pressure levels
can cause seizures, kidney or heart failure but
for most children, there are no symptoms and
hypertension is discovered on a routine
examination, often when you child wants to try out
for a sports team.
How is it diagnosed?
High blood pressure is diagnosed by measuring
the blood pressure as part of your child’s regular
medical care. Occasionally, your doctor will get a
high reading but suspect that your child was
anxious or excited and the reading doesn’t really
reflect your child’s true blood pressure. If
that’s the case, your doctor will certainly note
the reading and plan to recheck the blood pressure
on another occasion. Unless the blood pressure is
very high or there are other symptoms to make the
doctor suspect that the reading is correct,
Doctors don’t make the diagnosis of high blood
pressure based on only one blood pressure reading.
Once your doctor is convinced that your child has
high blood pressure, the amount of testing to be
done depends upon your child’s age and how high
the blood pressure is. In general, the younger the
child and the higher the blood pressure, the more
likely we are to find a specific cause and the
more testing needs to be done. Particularly when
younger children are affected or when the blood
pressure is very high, your doctor may choose to
consult with a pediatric kidney and hypertension
expert to help determine the cause of the high
blood pressure.
What is the treatment?
The treatment of hypertension depends upon it’s
cause. If a specific cause of high blood pressure
can be found the treatment is directed at that
cause. Occasionally, this will require surgery to
repair or remove part of a damaged kidney or a
narrowed blood vessel. More often, hypertension is
treated with medication. Fortunately, today,
doctors have several very effective blood pressure
medications but sometimes it isn’t the first
choice that works and your doctors will have to
find the right medicine at the right dose for your
child. In addition, all patients with high blood
pressure should limit their salt intake and engage
in regular aerobic exercise. Both of these
treatments have been shown to be effective in
helping lower high blood pressure. Once your child
is under treatment, you doctor will want to
monitor the blood pressure. As you child grows
he/she will need to have the dose adjusted to
prevent the return of the hypertension.
Self-care tips
Good nutrition, preventing excessive weight
gain, limiting salt intake and regular aerobic
exercise have all been shown to be helpful in
preventing and treating high blood pressure. The
eating and exercise habits your children grow up
with are probably those that will stay with them
throughout their lives. “An ounce of prevention is
worth a pound of cure.”
This information has been designed as a comprehensive and quick reference
guide written by our health care reviewers. The health information written
by our authors is intended to be a supplement to the care provided by your
physician. It is not intended nor implied to be a substitute for
professional medical advice.
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