High Blood Pressure in Children?  You’re kidding!

The incidence of high blood pressure (hypertension) in children has risen significantly over the past 2 decades.  The increase is thought to be linked to increases in body weight, diets high in fat and cholesterol, and sedentary lifestyles.  These factors not only raise the blood pressure (BP) to unhealthy levels, they increase a child’s risk for developing Type 2 Diabetes Mellitus (formally known as adult-onset diabetes).  Because hypertension can lead to strokes and heart attacks in adulthood, addressing the problem early in life makes good sense. 

Two types of high blood pressure exist: essential hypertension (no identifiable cause) and secondary hypertension (the result of another disorder).  Although most cases of hypertension in children are caused by kidney, heart, endocrine, or neurologic disease, the increase of hypertension in relatively healthy children (essential hypertension) is a source of concern.  (To learn more about hypertension, click here.  After completing the tutorial, take the quiz and see how you score.)

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Note: A diagnosis of hypertension should NEVER be based on one (1) reading alone. Blood pressure elevations must be noted on 2 additional and separate visits. The child should be at rest and equipment should be properly sized for children.

Symptoms of High Blood Pressure

High blood pressure is a silent killer.  Few symptoms are apparent until the individual begins experiencing complications.  Indeed, most cases of high blood pressure are detected during routine physical exams.  However, with consistent or severe elevations of BP, the following symptoms may be experienced: frequent headaches, dizziness, changes in vision, or seizures.  With infants, behavioral cues such as increased irritability or head rubbing/banging may be noted.

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How is pediatric hypertension treated?

With secondary hypertension, the underlying cause must be treated.  Because no identifiable cause exists in essential hypertension, pharmacologic AND nonpharmacologic treatments may be used to lower the child’s BP levels.  Nonpharmacologic measures (or lifestyle changes) may include a low-fat, high-fiber, low-sodium diet, a weight reduction plan, and a regular exercise program.

Medicines are reserved for children with BP elevations that do not respond to lifestyle changes.  Children requiring medicine may take diuretics, beta blockers, or vasodilators.  If you have a child needing blood pressure medication, learn about the medicine AND the impact of the medicine on the child.

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New Blood Pressure Guidelines

Management Strategies for Pediatric Hypertension

(Parents)

1. All children should begin receiving regular blood pressure checks by 3 years of age.  If this is not being done during routine visits to the doctor, insist that they be included.
2. An isolated high blood pressure reading does not constitute a diagnosis of hypertension.  Make sure you return to your health care provider for all necessary repeat assessments.
3. If your child has been diagnosed with “pre-hypertension,” work with your physician to incorporate appropriate lifestyle changes into your child’s daily routine.
4. Learn about hypertension and its implication over the life span.
5. Learn about the proper way to assess your child’s blood pressure, should home blood pressure measurements be advised.
6. Become positive role models for your children.  Promote healthy eating with all members in your household and encourage regular physical activities.  Discourage sedentary activities.
7. Always remember to provide liberal praise for even minor lifestyle changes.

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(Faculty and School Staff) 

1. Become a positive role model.  Encourage regular physical activity and healthy eating behaviors in your students by becoming healthy eaters and exercising regularly.  Remember: children learn by example. 
2. Work with parents and staff about creating a blood pressure screening program in your school.  This program can be included with the Body Mass Index Screening Program currently mandated in the State of Arkansas. 
3. Include age-appropriate lessons about blood pressure and the value of exercise and healthy diet in your curriculum.
4. Allow students requiring blood pressure screening or medications for hypertension to visit the school nurse when necessary.
5. Make sure your school has all the appropriate equipment for measuring blood pressure in children.  Various sizes of blood pressure cuffs will be needed to ensure accuracy of readings.
6. Consider sponsoring education programs for families in your community about diet, exercise, weight control, and smoking cessation.  Work with your local health department, hospital, clinics, and medical community regarding community education.  When members of a community participate in health-promoting programs, lifestyle changes tend to be long-lasting.
7. Consider sponsoring exercise programs with activities children enjoy (i.e., team sports)
8. Remember to praise even minor lifestyle changes made by your students.
   
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