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High Blood Pressure in Children

By Mara P. Paradis, M.D.

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The epidemic increase of childhood obesity is in the spotlight; on nighttime news reports, articles in health magazines and in pamphlets handed out at pediatrician offices. The reality of childhood obesity is visible in our day to day lives; however, the dangers associated with obesity are deeper than plain sight. Among other complications, high blood pressure in children has a very real and very scary correlation with obesity. The effects of high blood pressure can lead to serious medical problems in children now and as they progress into adulthood.

High blood pressure or hypertension can be present in all ages, from infancy to adulthood. Five percent of the childhood population has higher than normal blood pressure. This five percent needs to be fully evaluated and monitored closely to avoid potentially life-threatening damage to the body’s vascular system.

There are two types of hypertension: primary or essential hypertension and secondary hypertension. Secondary hypertension means that a specific cause of the high blood pressure can be identified. Children with this type of hypertension may have other serious medical conditions such as kidney disease, heart disease or abnormalities with the nervous or endocrine (hormone) system. The development of essential hypertension is closely associated with one’s diet, exercise habits and family history.

High blood pressure may be associated with symptoms such as:

  • Headache
  • Dizziness
  • Fatigue
  • Visual disturbances

Most often, a child with high blood pressure does not have any overt symptoms. This highlights the importance of bringing your child to your pediatrician for regular health care maintenance examinations. A child’s blood pressure should be checked yearly after three years of age and anytime a child presents signs or symptoms of conditions that are know to be associated with elevations of blood pressure.

In children with secondary hypertension, your pediatrician will work, often in conjunction with a specialist, to control both your child’s blood pressure and the underlying cause of the elevated blood pressure. Children diagnosed with essential hypertension can often decrease their blood pressure by making dietary and other lifestyle changes. Your pediatrician can provide guidance in developing a healthy diet and exercise program. If changes in diet and exercise are not enough to lower your child’s blood pressure, your pediatrician may recommend the use of medicines to treat the hypertension.

Chances are that your child is not among the five percent of children with high blood pressure. However, it is important to follow up regularly with your child’s pediatrician to make sure that if your child does have high blood pressure or any other risk factors, such as obesity and/or lack of exercise, that these concerns are addressed as early as possible to avoid any long term damage to the body.

Parents can help their child develop a healthy lifestyle—reducing the risk of developing hypertension—by teaching him/her to make healthy food choices and how to incorporate exercise into daily life. The development of a healthy lifestyle in childhood will lay the foundation for your child to develop into a healthy adult.

Q&A

When should I seek professional help if my child is overweight?

Children should be seen by their pediatrician for regular health care maintenance visits. During these visits, your child’s height and weight will be measured and his body mass index will be calculated. These values will be plotted on a growth chart and reviewed with you and your child. Children with a body mass index of greater than 85% are at risk for obesity and those with a body mass index great than 95% are considered overweight. If your child falls outside the normal range, your pediatrician will help you develop a diet and exercise treatment plan.

Could my child have a medical condition that causes him to be overweight?

Although rare, some children do have underlying medical conditions that cause them to be overweight. These conditions are diagnosed by a thorough history and physical exam as well as disease specific laboratory testing. If you have concerns regarding your child’s weight, make sure to bring them up to your pediatrician.

If my child is overweight, would exercise elevate his blood pressure to unsafe levels?

If you child has been diagnosed as being overweight or obese, your pediatrician will help you develop an appropriate exercise program. In the majority of cases, exercise is extremely beneficial in maintaining a healthy weight as well as lowering one’s blood pressure. However, any extreme changes in exercise programs should be first cleared by your pediatrician.