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With adults, measuring the blood pressure is fairly systematic and clear process. However, when it comes to children, things get a bit trickier, as the values which are considered normal will change as the child grows.

High blood pressure, contrary to popular belief, isn’t just a condition that affects the elderly segment of citizens. Young people, those under the age of 35, as well as children can suffer from hypertension, although the causes are a bit different and more specific.

Pediatric hypertension: Symptoms

Just as with adults, high blood pressure in children doesn’t show any obvious symptoms. In its more advances stages, specifically during a hypertensive crisis, symptoms may include shortness of breath, headaches, heart palpitations, chest pains, seizures, and vomiting.

What causes pediatric hypertension?

As far as children are concerned, high blood pressure is typically a consequence of other health conditions, which can range from kidney to heart disease. The younger the child is, the likelier it is for the elevated pressure to be linked to an illness. For example, babies can have hypertension because they were born prematurely, but they can also have kidney problems, heart, or lung deficits.

While not that common, bronchopulmonary dysplasia is an example of a health condition that can cause hypertension in babies, one that involves lungs not being properly matured when the baby is born.

As the child grows older, parents have to watch out for the little one’s diet, as obesity is a cause for concern in children and adults alike. Hypertension among children is strongly linked to obesity, especially in a modern society with two working parents that don’t always have the time to monitor the child's eating habits.

The doctor will also have to determine if the hypertension that a child suffers from is primary of secondary.

Primary (or essential) hypertension can be caused by:

  • Genetic factors, such as being Hispanic or being a male.
  • Inhaling second-hand smoke (or smoking).
  • Not getting enough physical activity.
  • Having a high sugar level.
  • Being overweight/obese.
  • Having a large salt intake, which can be a consequence of eating salty snacks.

Secondary hypertension is the cause of other health problems, and it’s more common in children compared to essential hypertension. Some of the causes may include:

  • Kidney disease.
  • Adrenal disorders or an adrenal gland tumor.
  • Renal artery stenosis.
  • Heart problems.
  • Hyperthyroidism.
  • Sleep disorders, which are more common in teens that don’t have a well-defined sleeping schedule and children who suffer from disorders such as ADHD.

Although no parent wants to hear this, secondary hypertension can also be caused by illegal drugs, such as cocaine.

Pediatric hypertension: Diagnosis

Aside from interpreting blood pressure in children, which is a bit more complicated than with adults, diagnosis and treatment of this problem are very similar. Hypertension in children can be diagnosed during a routine exam, which may also require parents giving out information on the child’s medical history, as well as family medical history. Information on the child’s diet and physical activity is also needed.

For the actual reading, doctors use a specific blood pressure monitor, with a cuff that’s properly sized, making the reading more accurate. For the best results, doctors can choose to read the blood pressure two or three times during a single appointment.

Even if a reading is high, doctors will diagnose a child with high blood pressure only after three consecutive visits. It’s also important for the doctor to determine if the child’s blood pressure is essential or secondary.

There are also other tests that doctors can perform to confirm that they are, indeed, dealing with high blood pressure.

  • Blood tests are particularly common and useful, as they reveal information about the child’s blood cell counts, how well the kidneys function, and reveal the blood sugar levels from their organism. 
  • Urine sample tests are non-invasive, but can also give doctors important information about your child’s current health state.
  • Echocardiograms are tests that analyze the heart’s blood flow. If doctors suspect that the heart may be the cause of your child’s high blood pressure, they will turn to an echocardiogram to confirm it.
  • If a doctor has reason to believe that the kidneys are a problem, they can also choose to perform an ultrasound of the kidneys to confirm their suspicions.

Important note: Doctors that suspect hypertension in a child can choose to perform ambulatory monitoring. This process implies having the child wear a monitoring device, which can measure blood pressure for a longer period of time. This includes sleeping, but also day-to-day activities. This will help determine if the child’s blood pressure is raised because of anxiety of medical examination (which is known as “white-coat hypertension”).

Pediatric hypertension: Treatment

Children with mild to moderate hypertension will receive lifestyle recommendation that must be carefully seen through by their caregivers. Doctors will avoid prescribing blood pressure medication to children if they suspect that the condition might be treated with a better diet and more physical activities.

If lifestyle changes fail to cause a drop in blood pressure, or if the child is in a more advanced hypertension stage, doctors will then prescribe medication that’s used to treat the problem, such as:

  • ACE inhibitors - which help the blood vessels relax, thus improving blood flow.
  • Calcium channel blockers - medications that can slow the heart rate and cause the blood vessel muscles to relax.
  • Beta blockers - medications that take the strain off your child’s heart, and lower heart rate.
  • Diuretics - also known as water pills, they can prevent your child’s kidneys from retaining water and sodium, whose build up can increase blood pressure.

Conclusion

With adults, measuring the blood pressure is fairly systematic and clear process. However, when it comes to children, things get a bit trickier, as the values which are considered normal will change as the child grows. If an adult can monitor their own blood pressure at home and knows how to interpret the reading, values for children are subject to change, which means that it’s best to leave this in the hands of doctors.

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