The American Academy of Pediatrics (AAP) recently released new guidelines for pediatric hypertension, or high blood pressure, measurement and treatment. UnityPoint Health Pediatric Cardiologist, Dilli Bhurtel, MD, explains what parents should know when it comes to high blood pressure in kids.
1. How is blood pressure measured in kids?
Around 3.5 percent of children are found to have high blood pressure,” Dr. Bhurtel says. “The new guidelines outline the standards for detection and management of high blood pressure in children between 0-18 years of age. Blood pressure is measured in kids just like in adults, using the oscillometer technique, which is the cuff around the arm. If the blood pressure reading is high, then we take the blood pressure again with the auscultatory technique, which uses both the cuff and the stethoscope."
2. Does my child need his/her blood pressure checked?
Children 3 years and older should have their blood pressure checked annually during their well-child visit. Children who have obesity, are taking medications known to increase blood pressure, have renal disease, a history of aortic arch obstruction (coarctation) or diabetes should have their blood pressure checked at every visit.
3. My child’s blood pressure measurement was high in the office, does that mean he or she has hypertension?
One high blood pressure reading isn’t enough to determine hypertension. Your doctor or health provider will check the blood pressure in at least three different visits to determine if there is a concern.
“If the blood pressure is high and is at the elevated blood pressure stage for a year or more, or blood pressure is high and falls on the stage one hypertension level, your child will wear a cuff for 24 hours to measure blood pressure during that time. This will help to determine that the increase in blood pressure is not just being nervous in the doctor’s office,” Dr. Bhurtel says.
If a child’s blood pressure measurement at clinic visits is consistently high, then he or she will be diagnosed with hypertension.
4. What is now considered normal and high blood pressure for kids?
The AAP released a table based on a child’s age and height to set what’s called a normative value to determine whether or not a child has high blood pressure.
“Once children reach 13 years old, they’ll transition to using adult blood pressure measurement standards. For adults, any result less than 130 (top number) and less than 80 (bottom number) is considered normal,” Dr. Bhurtel says.
5. What causes high blood pressure in kids?
Children who have obesity or a family history of high blood pressure have a greater risk. If your child is younger than 6 years old or has abnormal findings on an exam, he or she will be evaluated for the possible causes, like kidney disease, a narrowing of the aorta (coarctation of aorta) or hormonal causes.
6. What risks does high blood pressure pose to children?
Dr. Bhurtel says while the health risks might not appear in childhood, untreated high blood pressure in kids will lead to organ damage.
“Without diagnosis, a child’s high blood pressure could go undetected until adulthood. Health risks from high blood pressure include early heart attack, stroke, kidney failure and blindness. Thus, as a physician and care provider, our responsibility is to prevent these devastating effects of hypertension,” Dr. Bhurtel says.
7. If my child has high blood pressure, what does that mean for treatment?
After much testing, doctors start by recommending a combination of diet and exercise to help bring blood pressure down. Regular follow up appointments will check whether or not diet and exercise is working. If it isn’t, that’s when doctors consider adding medication.
“Medication is the last resort we want to pursue, but with stage two hypertension, we start the medication right away. Care providers, patients and parents work closely to set up goals to manage this silent, but serious, condition. Educating the patient, parents and the heath care provider regarding the easily available therapies is the key. Diet and exercise are able to control the blood pressure in majority of cases, and only a very few patients will need medication. This is a journey we can take together over time,” Dr. Bhurtel says.
8. How long should diet and exercise be used for treatment?
Dr. Bhurtel says lifestyle changes should be a way of life, not only for kids, but for parents/adults, too.
“As a children’s heart specialist, I am very concerned with the rise in obesity, its association with hypertension and the potential related effects. I take time to educate my patients and parents about this silent, but potentially serious, condition of hypertension. High blood pressure can be prevented by choosing a healthy lifestyle: eating healthy diet and performing regular exercise,” Dr. Bhurtel says.
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