Finding and Treating Hypertension in Kidsby Nicole Van Hoey, PharmD Health Professional
High blood pressure remains a slow and silent killer globally, and especially in the United States.
As 21st century diets become more varied, and more healthful choices are available year-round, though, you might expect to see improvements in food-related diseases like obesity, diabetes, or hypertension (the clinical term for high blood pressure).
On one hand, these changes are happening, if somewhat slowly: Almost 70% of adults diagnosed with hypertension are being treated with medicine, and public health costs decreased by almost $30 billion between 2010 and 2015. But, on the other hand, increased problems remain overlooked in one surprising population: children.
Why would kids have high blood pressure?
Kids of any age can be diagnosed with essential hypertension—the type of high blood pressure that indicates no outside disease cause, like a genetic condition. In the youngest ages, high blood pressure usually is caused by something else, like a kidney disease. But high blood pressure in older, otherwise-healthy children is most often linked to obesity. Having high blood pressure in childhood is directly linked with continued and worsened high blood pressure in adulthood, too.
So, what is a high blood pressure measurement in kids? Blood pressure is measured when the heart is beating (systolic, or top number) and at rest between beats (diastolic, or bottom number). Hypertension is diagnosed in adults with systolic blood pressures of 130 mmHg or more. Because blood pressure increases with age, normal measures in kids are lower than in adults. Systolic pressures of 120-130 mmHg are considered persistently elevated blood pressure in teens, for example.
Health professionals use standards (updated in 2017) that combine height and age in otherwise-healthy kids to diagnose high blood pressure. These standards differ between girls and boys, especially in the youngest ages. Here are just a few examples of normal and hypertensive childhood pressures:
For an average-height 8-year-old girl, a systolic pressure of 98 mmHg is normal, and a pressure over 111 mmHg is not.
For an average-height 8-year-old boy, a systolic pressure of 98 mmHg is normal, but a pressure over 110 mmHg is not.
Blood pressure of 120/80 mmHg or more in boys and girls of any age is considered too high.
Can children with hypertension take medicine to help?
High blood pressure might not change how your child feels, but it can damage organs like the kidneys, lungs, and heart anyway if it isn’t treated. Medicines for high blood pressure are tested in adult patients for efficacy (whether it works as well as it should) and safety (whether its risks are less than its benefits). Just like adults with hypertension, kids need life and diet changes first, before medicine is considered.
Some types of medicines used safely in children to treat high blood pressure that has lasted nearly 6 months without getting better are ACE inhibitors and diuretics combined with drugs called beta blockers (one example is bisoprolol/hydrochlorothiazide).
How can I stop hypertensive disease in my own family?
If you are a parent or otherwise a caregiver of children, you can promote a healthy lifestyle to build habits that will protect against diseases like hypertension for a lifetime:
Eating: The USDA MyPlate program includes free information about filling plates with healthy meals for kids and their families.
Exercise: Encourage your child to find a favorite hobby, like tree climbing, that makes activity seem more fun than exercise.
Symptom awareness: Teach your child to recognize changes related to heart problems, like new shortness of breath or tiredness from typical activities, like gym class.
Confiding fears: Make sure your child can talk with you or another trusted adult about worries he or she might have, like whether it’s okay to play sports or if hypertension can go away.
Be a good example, too, for kids who are already diagnosed with hypertension. If your child has diseases related to weight or lifestyle, it’s possible you might, too. Consider seeing a dietician or nutritionist for the entire family to prevent or reverse damage from hypertension.
If you and your child are already trying to reverse blood pressure damage, try to
avoid anxiety by getting a good night’s sleep and time together to relax
take family hikes or even just walks around the block together
cook together in the kitchen to interest kids in making food at home
track blood pressure changes by taking measures at home and keeping a diary
Know that you aren’t alone, even if taking care of a child with high blood pressure seems overwhelming. To successfully change lifestyle changes and healthy habits, parents must have a lot of help from the child’s pediatrician or heart doctor and from the school and local community services.
Learn more about medicines that have been used in kids for high blood pressure so that you can ask informed questions of the pediatrician or heart doctor who cares for your child. Don’t hesitate to ask the doctor to take your child’s blood pressure, too, and tell you what those numbers mean at each office visit.