Hypertension and Children

AHA recommendation

Children and even babies can have high blood pressure. The AHA recommends that all children have yearly blood pressure measurements. Early detection of high blood pressure will improve the health care of children.

High blood pressure in children can be caused by other diseases — usually heart or kidney disease. This is called secondary hypertension. If the other disease is successfully treated, blood pressure usually returns to normal. Some medicines can cause high blood pressure, but when they are discontinued, blood pressure usually returns to normal.

At one time doctors thought that most all high blood pressure in children was secondary (i.e., caused by other disease). They now know this is not so. A small number of children have higher blood pressures than others for unknown reasons. These children are said to have primary or essential hypertension.

Research scientists do not know why some children have higher blood pressure than others. Children who are overweight usually have higher blood pressure than those who are not.

Some children inherit the tendency from one or both parents who have high blood pressure. High blood pressure is more frequent and more severe in families of African-Americans than in whites. The reasons are not fully understood.

A special diet and physical activity may be prescribed by the doctor to lower high blood pressure in overweight children. Although cigarette smoking is not directly related to high blood pressure, youngsters who smoke should stop for a variety of health reasons. Parents should set a good example by not smoking and help educate their children about the hazards of smoking. The doctor may also prescribe medication.

In a recent report that analyzed the national childhood blood pressure data, the blood pressure percentiles were refined. Now they are based not only on sex and age, but also on height to determine age-, sex- and height-specific systolic and diastolic blood pressure percentiles. This approach provides information that allows for consideration of different levels of growth in evaluating blood pressure. It also demonstrates the blood pressure standards that are based on sex, age and height and allows a more precise classification of blood pressure according to body size. More importantly, the approach avoids misclassifying children at the extremes of normal growth.

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