Once rare, high blood pressure in children and adolescents has become increasingly common in recent years. High blood pressure, also called hypertension, is a leading risk factor for serious diseases in adulthood, including cardiac disease and stroke. You can reduce the risk of these diseases by helping your child control high blood pressure through diet, exercise and medical care. It may also be helpful to discuss your child's condition with his teachers.
Diagnosis
There is no one-size-fits-all target blood pressure level for children. A pediatrician can evaluate a child's blood pressure based on age and height percentile tables. A child is considered to have high blood pressure when her reading is in the 95th percentile for her age and height. For example, a five-year-old in the 50th percentile, or median range, for height with a blood pressure reading of 110 systolic over 72 diastolic is in the 95th percentile for blood pressure. This means her blood pressure is higher than that of 95 percent of other children her age and height.
Causes and Risk Factors
Secondary hypertension is the more common form in children, meaning it is a symptom of another medical disorder. Possible causes include heart problems and kidney disease. Primary hypertension, or high blood pressure not symptomatic of another disease, is associated with childhood obesity and genetics. Obese children are at a three times greater risk for hypertension than are their non-obese peers. About half of all children with primary hypertension have a close relative who also has high blood pressure.
Treatment
A reading in the 95th to 99th height percentile for age is considered Stage 1 hypertension. Lifestyle changes, including diet and exercise, are often sufficient to control Stage 1 hypertension. A reading in the 99th percentile or higher marks Stage 2 hypertension, which in addition to diet and exercise may require one or more types of medication. The medication used in drug therapy depends on the severity and cause of the condition and may include diuretics, beta blockers or other drugs.
Diet
Children with hypertension and pre-hypertension should follow a low-fat, low-sodium diet. Sodium intake should be restricted to 1,200 mg per day or less. Fast food and processed foods are typically very high in sodium and should be avoided or eaten in moderation. The Mayo Clinic recommends high-fiber breakfast choices as well as fruits, vegetables and whole-wheat grains in place of junk food. Consult a physician before putting your child on a diet for high blood pressure.
Fitness
Children should get about 30 minutes of aerobic exercise per day on most days of the week. Significant weight loss may require 60 minutes of aerobic exercise per day. Children with hypertension should not lift weights as this can increase blood pressure. Check with your child's physical education teacher to make sure he is receiving adequate exercise in school. Also, initiate physical activities at home, rather than allowing him to be sedentary.
References
- American Academy of Family Physicians: Hypertension in Children and Adolescents
- National Heart, Lung and Blood Institute: Blood Pressure Tables for Children and Adolescents
- MayoClinic.com: High Blood Pressure in Children
- Louisiana State University Health Sciences Center: Treatment of Hypertension in Pediatrics
- California Pacific Medical Center: Evaluation and Management of Hypertension in Children and Adolescents
