High Blood Pressure in Children
(Hypertension in Children)
Blood pressure is the force of blood on the blood vessel walls. High blood pressure is when the force is higher than normal. It is measured as two numbers:
- Top number—the pressure when heart is squeezing
- Lower number—the pressure the heart is at rest
High blood pressure can cause damage to blood vessels and certain organs. The damage gets worse over time. It can lead to a higher risk of heart and kidney disease or stroke in early adulthood.
High blood pressure can affect the body in many ways.
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The cause of high blood pressure will depend on the type:
- Essential (or primary)—The cause is not known.
- Secondary—Another illness is causing the problem.
Things that may increase the risk of essential high blood pressure are:
- A diet high in salt
- Having other family members who have high blood pressure
Things that may increase the risk of secondary high blood pressure are:
High blood pressure will often not cause any symptoms. Some children may:
- Have a headache
- Feel dizzy
- Have vision problems
- Feel tired
Normal blood pressure in children is different from adults. It will also vary by gender, age, and height. The range of normal blood pressure will change as the child grows.
Blood pressure is measured at least once per year after 3 years of age. A chart will show what a healthy blood pressure range is based on a child’s gender, age, and height. A high blood pressure needs to happen on more than one measurement to be diagnosed. The doctor may also ask that a measurement be done at home. This will rule out normal increased blood pressure due to anxiety at a doctor's office.
Other tests may be done to look for a cause.
The treatment plan will be based on the cause. Treating related conditions may return blood pressure to normal. It is important to treat high blood pressure. It can prevent serious health issues in adulthood.
Steps that may treat essential high blood pressure or manage secondary high blood pressure are:
- A healthy diet that is high in fruits and vegetables and whole grains. Salt may also need to be tracked or lowered.
- Weight loss for children who are overweight.
- Regular physical activity. This includes sport, play, and less screen time.
Some blood pressure may not be lowered by above changes. Medicine may then be needed. Types of blood pressure medicine are:
- Angiotensin-converting enzyme inhibitors (ACE inhibitors)
- Angiotensin receptor blockers (ARBs)
- Calcium channel blockers
Healthy habits can help prevent some types of high blood pressure:
- Eating a healthful diet that is rich in fruits, vegetables, and whole grains
- Maintaining a healthy weight
- Getting regular physical activity
- Limiting screen time
- Flynn JT, Kaelber DC, Baker-Smith CM, et al; Subcommittee on Screening and Management of High Blood Pressure in Children. Clinical Practice Guideline for Screening and Management of High Blood Pressure in Children and Adolescents. Pediatrics. 2017 Sep;140(3).
- Hypertension in children and adolescents. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/hypertension-in-children-and-adolescents.
- Screening and treating kids for high blood pressure: AAP report explained. Healthy Children—American Academy of Pediatrics website. Available at: http://www.healthychildren.org/English/health-issues/conditions/heart/pages/High-Blood-Pressure-in-Children.aspx.
- Nicole S. Meregian, PA
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