Monitoring blood pressure is an important part of maintaining good health, especially cardiovascular health. According to Dr. Farpour-Lambert of the University Hospitals of Geneva in Switzerland, the foundation of cardiovascular disease develops during childhood. Dr. Farpour-Lambert says, "There is evidence that from the age of 4 we can see the first signs of atherosclerosis." With obesity rates on the rise, it is important to have children's blood pressure checked regularly.
Screen at an Early Age
According to a 2009 report by the American Academy of Pediatrics, almost 75 percent of cases of hypertension and 90 percent of cases of prehypertension in children from 3 to 18 years of age go undetected. Since childhood hypertension can lead to cardiovascular disease in adults, the American Academy of Pediatrics and the American Heart Association recommend that blood pressure screening begin at age 3 and continue with each health care visit.
Blood Pressure Ranges
There is a broad range of acceptable blood pressures for children and adolescents, since the child's age, gender and height percentile must be factored in, according to the American Academy of Pediatrics. Using the lower limit of height in the abnormal blood pressure range along with other parameters, the Academy developed a simplified table of blood pressures that warrant further evaluation. The table gives the systolic, or top number, and the diastolic, or lower number, pressures that are considered a cutoff for prehypertension.
A blood pressure equal to or greater than 120/80 is considered prehypertension.
Hypertension Causes
With the rise in childhood obesity, hypertension is being seen more in the pediatric population. The American Academy of Pediatrics states that about five out of every 100 children have higher than normal blood pressure. Fortunately, less than one in 100 has medically significant hypertension. The Academy further states that hypertension tends to develop with age, and in most cases, no known cause can be identified besides obesity. Severe hypertension in children usually indicates other problems, such as abnormalities of the heart or endocrine system or kidney disease.
Signs and Symptoms of Hypertension
According to the American Academy of Pediatrics, hypertension often does not have any symptoms, indicating the importance of regular blood pressure checks. There are a few signs that blood pressure may be elevated such as shortness of breath, fatigue, headache, dizziness and changes in vision. Ignoring these signs may lead to adult-onset heart failure, stroke and eye or kidney damage.
Researchers at Cincinnati Children's Hospital in Ohio further warn that hypertension in children causes enlarged hearts and early stages of arterial disease. Enlargement of the heart, or left ventricular hypertrophy, causes the heart's main pumping chamber to become thicker from the extra work needed to pump blood into vessels against increased resistance caused by hypertension. Over time, the heart stiffens and can't pump blood efficiently. This increases the risk of heart failure, heart attack and sudden cardiac arrest in adults.
Management and Prevention
Based on the blood pressure elevation, the child's physician will decide if medication is needed or not. The Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents from the National Institutes of Health states that prehypertension does not require medication unless the child has chronic kidney disease, diabetes, heart failure or enlargement of the heart.
Instead, they emphasize physical activity and limiting sedentary activities such as playing video games to less than two hours daily. Parents are encouraged to find physical activities the child enjoys with a goal of 30 to 60 minutes of exercise daily. A healthy diet is key and should include a variety of fresh fruits and vegetables, limiting sugary foods and drinks, portion control and reducing salt intake.
References
- The Wall Street Journal: Doctors Focus on Kids' Blood Pressure
- American Academy of Pediatrics: Can children get high blood pressure?
- American Academy of Pediatrics: Simple Table to Identify Children and Adolescents Needing Further Evaluation of Blood Pressure
- U.S. Department of Health and Human Services: The Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents
