Preventive Cardiology
High blood pressure
Most people don't realize that high blood pressure—a common problem affecting more than 60 million adults in the United States—can also occur in children. In fact, high blood pressure in adults can have its roots in childhood. In the past, elevated blood pressure was uncommon in children, but steady increases in childhood obesity rates (which can elevate blood pressure) have put more kids at risk.
What is hypertension?
Blood pressure is the pressure exerted on your blood vessel walls by the pumping of the heart. ‘Hypertension’ describes blood pressure elevated above the normal range, which in children depends on their age, relative height and gender. Over time, consistently elevated blood pressure can damage blood vessels and vital organs such as the kidneys, brain and heart. It's also a major risk factor for heart attack and stroke.
Elevated blood pressure can be dangerous at any age. Early intervention may help prevent cardiac-related symptoms now—as well as heart disease in the future.
What causes hypertension in children?
The majority of adolescents and children with hypertension over 6 years of age have a family history of obesity, are overweight or obese themselves, or both. Many may also have a family history of hypertension. Some children may have underlying medical conditions that cause hypertension, such as kidney disease, disorders of the endocrine system or blood vessel abnormalities. More commonly, underlying medical conditions are the cause of hypertension in infants and young children. Some children may have no outwardly apparent reason for high blood pressure; this is known as “essential” hypertension.
How is blood pressure measured?
Most people are familiar with the inflatable cuff and stethoscope that clinicians use to measure blood pressure. But many people don't fully understand what the measurement means, even though blood pressure exams are routinely administered at regular doctor’s visits.
Blood pressure is measured in millimeters of mercury (mm Hg) on a sphygmomanometer (the tool on the inflatable cuff placed around your arm). Inflating the cuff compresses the main artery in your upper arm (the brachial artery), which closes the artery walls. As air gets released from the cuff, a thump is eventually heard and the health professional will record the number shown on the sphygmomanometer when they heard it.
This number represents the systolic pressure, or pressure exerted with a heartbeat. Systolic pressure is the top number in a blood pressure reading. The last sound indicates the diastolic pressure, or the pressure exerted as the heart rests. This is the bottom number in a blood pressure reading.
Blood pressure can be measured by several different methods, including an automatic machine. This may be a more convenient means of taking a blood pressure, but it's not always the most accurate and may overestimate one’s true blood pressure. If the readings are high, your doctor may recheck your blood pressure using a sphygmomanometer.
Is my child’s blood pressure too high?
If, after one measurement, high blood pressure is suspected, additional measurements must be taken on three separate occasions before a diagnosis of hypertension can be made. Blood pressure constantly fluctuates—changing along with activity level, temperature, medications, emotions and stress; so, one measurement may not be indicative of normal. While there's a single accepted normal range for blood pressure for adults, that range varies in children based on age, gender and height.
In general, children with blood pressure between the 90th and 95th percentiles are classified as having “pre-hypertension,” which means they're at risk for developing hypertension as they get older. Adolescents with blood pressure above 120/80 mm Hg should be evaluated for being pre-hypertensive.
How is high blood pressure in children treated?
If your child has hypertension, the Preventive Cardiology team will develop a plan that involves a combination of healthy eating, exercise, medication in some cases, and routine monitoring. For a general overview of what that plan may entail, please refer to The Heart Healthy Treatment Plan.
