Pediatric high blood pressure (hypertension)

What is pediatric high blood pressure (hypertension)?

The heart pumps blood to the whole body. Blood pressure is a measurement of how hard the blood pushes against the walls of the arteries (blood vessels that carry blood).

High blood pressure is also called hypertension. Long-term hypertension can lead to serious health issues later in life. High blood pressure can affect children of any age, including infants. According to the Centers for Disease Control and Prevention (CDC), one in twenty-five children in the United States has hypertension.

Blood pressure is made up of two measurements – systolic over diastolic. If either or both of these levels is consistently high, the child has high blood pressure.

• Systolic blood pressure is the highest pressure in the arteries as the heart pumps blood to the body.

• Diastolic blood pressure is the lowest pressure in the arteries when the heart relaxes and fills with blood between beats.

What are the different types of pediatric high blood pressure (hypertension)?

At Children’s Health specialists see three types of hypertension cases:

1. Primary hypertension is caused by things like obesity and inactivity. It is the most common type of high blood pressure we see at Children’s Health. It is more common in children who are 9 years and older.

2. Secondary hypertension is caused by another medical problem. This can make it more complex to treat and manage. It is more common in younger children.

3. White coat hypertension (also known as the white coat effect) happens when a child is nervous about having their blood pressure taken. Being nervous can cause a child’s blood pressure to rise.

Our specialists estimate that between one-third and one-half of kids with hypertension are just experiencing white coat hypertension.

What are the signs and symptoms of pediatric high blood pressure (hypertension)?

High blood pressure often doesn’t cause symptoms in kids. This is why it is very important to check blood pressure regularly at doctor visits. However, a child may have symptoms if their blood pressure suddenly shoots very high.

Schedule an appointment with a doctor if your child exhibits or often complains of:

• Headaches

• Dizziness

• Shortness of breath

• Visual disturbances or fatigue

• Frequent bloody noses

How is pediatric high blood pressure (hypertension) diagnosed?

For children less than 13 years old, normal blood pressure ranges vary based on gender, age and height.

For children age 13 and up, blood pressure ranges are:

• Normal - Less than 120/80

• Elevated blood pressure - 120-129/80

• Stage 1 hypertension - 130-139/80-89

• Stage 2 hypertension - 140/90 and up

If your child is diagnosed with stage 1 or stage 2 hypertension, the doctor will run blood and urine tests. The doctor may also perform painless imaging tests on your child’s heart or kidneys to see if the high blood pressure is affecting your child’s organs.

You will likely be asked to keep a diary of your child’s blood pressure at home to give the doctors more information. Your child may also need to wear an ambulatory blood pressure monitor (ABPM), a device that allows our team to check blood pressures over 24 hours.

What causes pediatric high blood pressure (hypertension)?

Pediatric hypertension is usually the result of one or more risk factors. These differ depending on the type of hypertension your child has.

Risk factors for primary hypertension include:

• Type 2 diabetes (high fasting blood sugar levels)

• Being overweight or obese

• Poor diet

• Being inactive

• Smoking

• Stress

Risk factors for secondary hypertension include:

• Heart defects

• Kidney disease

• Having been born prematurely

• Certain genetic conditions

• Hormonal disorders

• Obesity

How is pediatric high blood pressure (hypertension) treated?

The most common and effective way to treat high blood pressure in children is through changing some habits.

These changes can include:

• Eating a healthier diet (specifically, a low-salt diet)

• Maintaining an exercise routine

• Encouraging and motivating your child by making changes together as a family

At Children’s Health, we will work with you to help you make needed changes in ways that work for your family. Our pediatric specialists will schedule routine check-ups with your child to provide ongoing support and accountability. Our nutrition team can also help you brainstorm meal ideas that are tasty, nutritious and easy to make.

If these changes don’t work for your child, doctors may prescribe medications. They will monitor your child’s blood pressure levels carefully to be sure that the medications are working.