Disease: High blood pressure in children

    Overview

    High blood pressure (hypertension) in children is blood pressure that's the same as or higher than 95 percent of children who are the same sex, age and height as your child. There isn't a simple target blood pressure reading that indicates high blood pressure in all ages for children, because what's considered normal blood pressure changes as children grow.

    High blood pressure in children younger than 10 years old is usually caused by another medical condition. High blood pressure in children can also develop for the same reasons it does in adults — including being overweight, eating a poor diet and not exercising.

    Lifestyle changes, such as eating a heart-healthy diet and exercising more, can help reduce high blood pressure in children. But, for some children, medications may be necessary.

    Source: http://www.mayoclinic.com

    Symptoms

    High blood pressure in children usually doesn't cause symptoms.

    When to see a doctor

    Unless your child has an underlying health problem, you probably don't need to make a special visit to your child's doctor to have your child's blood pressure checked. However, your child's blood pressure should be checked during routine well-check appointments starting at age 3, and at every appointment if your child is found to have high blood pressure.

    If your child has a condition that can increase the risk of high blood pressure — including premature birth, low birth weight, congenital heart disease and certain kidney problems — blood pressure checks may begin during infancy.

    If you're concerned about your child having a risk factor for high blood pressure, such as being overweight or obese, talk to your child's doctor.

    Source: http://www.mayoclinic.com

    Causes

    High blood pressure in younger children is often related to other health conditions such as heart defects, kidney disease, genetic conditions or hormonal disorders. In older children — especially those who are overweight — the precise cause of high blood pressure is often unknown.

    Source: http://www.mayoclinic.com

    Diagnosis

    The test for high blood pressure is painless. Blood pressure is measured with an inflatable arm cuff and a pressure-measuring gauge.

    The cuff size used will vary with your child's arm circumference and any growth that has occurred. Your child may feel a tight squeeze around the arm when the cuff is inflated. You can find out what your child's blood pressure is immediately after the test is over.

    A blood pressure reading has two numbers. The first, or upper, number measures the pressure in your child's arteries when his or her heart beats (systolic pressure). The second, or lower, number measures the pressure in your child's arteries between beats (diastolic pressure).

    Normal blood pressure readings in children vary based on sex, age and height, so what may be a high blood pressure reading for a 4-year-old boy may be normal for a 10-year-old girl. Your child's doctor will let you know if your child's blood pressure readings are elevated.

    Your child won't be diagnosed with high blood pressure after only one blood pressure measurement. To diagnose high blood pressure, it takes three measurements that show your child's blood pressure is higher than normal over the course of at least three visits to the doctor. During a single visit, your child's blood pressure may be measured several times for accuracy.

    If your child's blood pressure is higher than normal, it should be checked about every six months after high blood pressure is first diagnosed.

    If your child is diagnosed with elevated blood pressure or hypertension, your child's doctor may also perform these tests to see if another condition is causing your child's high blood pressure:

    • Blood test to check your child's blood sugar, kidney function and blood cell counts
    • Urine sample test (urinalysis)
    • Echocardiogram, a test to check the blood flow through your child's heart, if your child's doctor suspects a structural heart problem may be causing high blood pressure
    • Ultrasound of your child's kidneys

    If your child's doctor is having difficulty diagnosing high blood pressure, or wants to monitor your child's treatment, he or she may recommend ambulatory monitoring. Your child's doctor may recommend ambulatory monitoring if your child has had elevated blood pressure for more than one year or stage 1 hypertension over three clinic visits. Ambulatory monitoring can help to confirm if your child has high blood pressure. In ambulatory monitoring, your child wears a device that measures his or her blood pressure throughout the day.

    Ambulatory monitoring can help to diagnose high blood pressure if your child's blood pressure is normal at the doctor's office and elevated at home. Ambulatory monitoring may also be helpful if your child is normally quite nervous at the doctor's office, because he or she may have what's known as white-coat hypertension — blood pressure that's only temporarily elevated due to anxiety from being at the doctor's office.

    Source: http://www.mayoclinic.com

    Complications

    Children who have high blood pressure are likely to continue to have high blood pressure as adults unless they begin treatment.

    A common complication associated with high blood pressure in children is sleep apnea, a condition in which your child may snore or have abnormal breathing when he or she sleeps. Pay attention to breathing problems your child may have while sleeping. Children who have sleep-disordered breathing, such as sleep apnea, often have problems with high blood pressure — particularly children who are overweight.

    If, as often happens, your child's high blood pressure persists into adulthood, your child could be at risk of:

    • Stroke
    • Heart attack
    • Heart failure
    • Kidney disease

    Source: http://www.mayoclinic.com

    Prevention

    High blood pressure caused by another condition can sometimes be controlled, or even prevented, by effectively managing the underlying condition. High blood pressure can be prevented in children by making the same lifestyle changes that can help treat it — controlling your child's weight, providing a healthy diet and encouraging your child to exercise.

    Source: http://www.mayoclinic.com

    Lifestyle and home remedies

    High blood pressure is treated similarly in children and adults, usually starting with lifestyle changes.

    • Control your child's weight. If your child is overweight, losing the excess pounds or maintaining the same weight as he or she gets taller can lower blood pressure.
    • Give your child a healthy diet. Encourage your child to eat a healthy breakfast that includes fiber and to avoid sugary cereals and beverages or products that have corn syrup solids listed as the first ingredient.

      Provide plenty of fresh fruits and vegetables in place of higher fat snacks like candy or chips. Trade white bread, rice and pasta for whole-wheat varieties. Try the Dietary Approaches to Stop Hypertension (DASH) diet, which emphasizes fruits, vegetables, whole grains, poultry, fish and low-fat dairy foods. Working with a dietitian can be helpful.

    • Decrease salt in your child's diet. Cutting the amount of salt (sodium) in your child's diet will help lower his or her blood pressure. Children ages 4 to 8 shouldn't have more than 1,200 milligrams (mg) a day, and older children shouldn't have more than 1,500 mg a day.

      Pay attention to how much salt you use in your cooking, and take the saltshaker off the table. Avoid giving your child salty snacks, such as chips or pretzels.

      Also, pay attention to how much sodium is in canned and processed foods your child eats, such as soups and frozen dinners. Limit the amount of fast food your child eats. Fast-food restaurants generally have high-salt menus as well as high-calorie foods.

    • Encourage physical activity. Children with high blood pressure generally need 30 to 60 minutes of physical activity at least three to five days a week to help reduce blood pressure. Limit your child's time in front of the television or computer — no television before age 2, and no more than two hours of "screen time" a day after age 2.
    • Get the whole family involved. It may be hard for your child to make healthy lifestyle changes if you or your child's siblings don't eat a healthy diet or exercise. So, set a good example. Your whole family will benefit from eating a healthier diet. You can also join in the fun of riding your bikes together, playing catch or walking to the park as a family.
    • Shop mindfully. Most of the time, your child can eat only the foods that you've purchased and made available. So, as the parent, bring healthy foods into your home and keep unhealthy foods out.

    Source: http://www.mayoclinic.com

    Risk factors

    Your child's risk factors for high blood pressure depend on underlying health conditions, genetics or lifestyle factors.

    Primary (essential) hypertension

    Essential hypertension is high blood pressure that occurs on its own, without an underlying condition. This type of high blood pressure occurs more often in older children, generally age 6 and older. The risk factors for developing essential hypertension include:

    • Being overweight or obese (a body mass index over 25)
    • A family history of high blood pressure
    • Type 2 diabetes or a high fasting blood sugar level
    • High cholesterol and triglycerides

    Secondary hypertension

    Secondary hypertension is high blood pressure that's caused by an underlying health condition. This is the type of high blood pressure that's more common in young children. Other causes of high blood pressure include:

    • Chronic kidney disease
    • Polycystic kidney disease
    • Heart problems, such as coarctation of the aorta
    • Adrenal disorders
    • Hyperthyroidism
    • Pheochromocytoma, a rare tumor in the adrenal gland
    • Narrowing of the artery to the kidney (renal artery stenosis)
    • Sleep disorders, especially obstructive sleep apnea
    • Certain medications, such as decongestants, oral contraceptives and steroids

    Source: http://www.mayoclinic.com

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