A child is diagnosed with hypertension when their average blood pressure is at or above 95th percentile for their age, sex, and height when measured multiple times over three visits or more.
A child’s blood pressure can be high due to a non-identifiable primary cause (essential hypertension) or an underlying medical condition (secondary hypertension—more common).
Research states that kidney disease is the main cause of high blood pressure in children.
Primary hypertension causes
Multiple factors may cause primary hypertension that typically affects older children (six years or older) and includes:
- Obesity
- Firsthand smoking or secondhand smoke
- Sedentary lifestyle
- High cholesterol levels
- Increased salt intake
- Being Africa American
- Male sex
- Having someone in the family with high blood pressure
- Having someone in the family with type II diabetes
Secondary hypertension causes
Secondary hypertension is typically encountered in children younger than six years and is caused by the following:
- Kidney conditions such as
- Chronic kidney disease
- Polycystic kidney disease
- Renal artery stenosis (narrowing of the artery to the kidney)
- Heart problems
- Contraction of the aorta
- Problems with the adrenal gland
- Hyperthyroidism (overactive thyroid)
- Obstructive sleep apnea (frequent episodes of cessation of breathing)
- Certain drugs and medications including
- Nasal decongestants
- Medications used for treating attention-deficit/hyperactivity disorder
- Nonsteroidal anti-inflammatory drugs
- Steroids
Does high blood pressure cause symptoms in children?
High blood pressure generally does not cause any signs and symptoms.
Symptoms that indicate extremely high blood pressure and necessitate seeking emergency medical help include:
- Headache
- Vomiting
- Chest pain
- Pounding heartbeat
- Shortness of breath
- Seizures
How can you prevent high blood pressure in a child?
You can take steps to prevent your child from developing high blood pressure by:
- Keeping their weight under control.
- Controlling the amount of salt and oil in their daily diet.
- Encouraging them to play and stay physically active.
- Taking treatment for the condition that can cause high blood pressure in your child.
How is high blood pressure treated in a child?
If your child has mild to moderate high blood pressure, your child’s doctor will first recommend making lifestyle changes in them before prescribing medications.
If the cause of high blood pressure is a medical condition, such as kidney disease or heart disease, your doctor will treat that condition.
Medications
These are prescribed for a severe grade of hypertension and include one or more of the following:
- Angiotensin-converting enzyme inhibitors
- Angiotensin II receptor blockers
- Calcium channel blockers
- Diuretics
Lifestyle modifications
Your child’s doctor will recommend the same lifestyle changes that are recommended for adults, which include:
- Control your child's weight: If your child is overweight, a decrease in even a few pounds every month can have a drastic effect on their blood pressure.
- Give your child a healthy diet: Encourage your child to eat lots of fruits and vegetables, lean proteins, beans, and whole grains but make them consume less of fast-food items and high-fat products.
- Decrease your child’s daily salt intake: Make sure that your child does not have more than 1,500 mg of sodium a day.
- Encourage physical activity: Let your child indulge in 60 minutes of moderate to vigorous physical activity a day. This may include sports, swimming, or even climbing.
- Limit screen time: Keep only a fixed duration for your child to watch their favorite cartoons on the television, laptops, or smartphone or for playing video games.
- Get the family involved: Your child follows what you eat. If you eat healthily, your child will emulate your eating habits.
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Pediatric Hypertension. https://emedicine.medscape.com/article/889877-treatment
Evaluation of hypertension in children and adolescents. https://www.uptodate.com/contents/evaluation-of-hypertension-in-children-and-adolescents
https://www.hopkinsmedicine.org/health/conditions-and-diseases/high-blood-pressure-hypertension/pediatric-hypertension
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