High Blood Pressure
While high blood pressure is primarily a problem among older Americans, it can occur in children—even newborns. About 1 percent of American children have high blood pressure.
Blood pressure is the measure of two forces— the force as the heart pumps blood into the arteries and through the circulation system, and the force from the arteries as they resist this flow. High blood pressure, known medically as hypertension, occurs when the blood pressure rises significantly above normal. This can have devastating effects on the body, because the higher pressure forces the heart to work harder.
Blood pressure is always measured using two numbers—the first number (systolic) measures the pressure while the heart beats, and the second number (diastolic) measures the blood’s pressure when the heart is resting between beats. In an adult, a blood pressure of 120/70 is considered very healthy; hypertension is considered to be 130/85.
Normal blood pressure readings are lower for younger children and rise with age, varying according to age, gender, and height of a child. An occasional high reading does not necessarily indicate hypertension, but consistent high readings could indicate a problem.
Cause
High blood pressure in childhood can usually be traced to a specific cause. Hypertension in a newborn may indicate congenital heart disease, such as a constriction in the aorta. If this constriction is strong enough, the baby’s heart could fail unless it is surgically repaired.
Between 80 percent and 85 percent of cases are due to kidney diseases. Less than 5 percent of high blood pressure cases are caused by hormonal disorders or tumors. Heart disease makes up less than 3 percent; rare cases of meningitis, encephalitis, and brain tumors are other known causes.
If a parent has high blood pressure, a child is twice as likely to develop the condition as someone with no family history. Children who are overweight usually have higher blood pressure than those who are not. In fact, most children have hypertension for the same reasons as adults: family history, obesity, and lack of regular exercise.
Symptoms
The most common symptoms are headaches, dizziness, and light-headedness, but these are often so mild that the child ignores them. Many children with high blood pressure have no symptoms at all. Irritability, excessive crying, failure to gain weight, poor feeding, and low-grade fever are the only symptoms in children younger than two or three years.
In severe cases, symptoms of encephalopathy, cardiac failure, blindness, or kidney failure occur and require hospitalization.
Diagnosis
The only reliable way of diagnosing hypertension is with regular blood pressure measurements. The most important thing is for parents to have their child’s blood pressure checked regularly by the pediatrician. An occasional high reading may only be due to nervousness while at the doctor’s office. On the other hand, consistently high readings taken over a period of time (three separate readings a week apart) are more likely to be caused by true high blood pressure.
A child with high blood pressure should then be checked further as part of a focused physical examination looking for evidence of damage. A test called an echocardiogram uses sound waves to assess the child’s heart and its function.
Treatment
Most doctors prefer not to prescribe medication to treat children who have mild hypertension. Instead, the doctor may try to lower blood pressure through weight loss, cutting down on salt, behavior modification (such as relaxation techniques), and exercise. Staying fit is important in weight and blood pressure control. A minimum of 30 minutes of aerobic exercise three to four times a week may help.
When the cause of hypertension is treated, blood pressure usually returns to normal. A child with high blood pressure is not doomed to struggle with hypertension as an adult, but a child who remains overweight, has high blood pressure readings, and has a family history of hypertension is at higher risk.
