Conditions + Treatments

Treatments for hypertension in children

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Contact the Hypertension Program

Learning that your child has high blood pressure can certainly be distressing, but it's almost always easily managed.

Most primary hypertension can be treated with changes in diet and exercise habits, and if necessary, there are medications that can help, too.

The good news is not all children require medication for high blood pressure. Many will improve with diet and exercise.

Your child's treatment plan may depend on:

  • whether the hypertension is primary or secondary (if secondary, treating the underlying condition may help resolve the hypertension)
  • the severity of blood pressure elevation

Pre-hypertension

Sometimes our doctors monitor children with pre-hypertension, seeing them once every six months or so. We'll provide counseling regarding healthy lifestyle choices to prevent progression to stage 1 or 2 hypertension.

Stage 1 hypertension

If your child has high blood pressure but is showing no symptoms, we may ask her to try three to six months of lifestyle modification (changes in diet and exercise). We may start by seeing her every three months, and if her hypertension is improving, gradually decrease the frequency of appointments depending on how things are going.

Stage 2 hypertension

We see children with stage 2 hypertension more frequently, although exactly how frequently depends very much on the individual child. If the hypertension is severe, we may start her on medication early, to get the hypertension under control, and follow up every two weeks if necessary. Once her blood pressure is brought under control, her appointments will be less frequent.

Diet and exercise

We encourage realistic and progress-oriented goals when it comes to making lifestyle changes like diet and exercise. Typically, we recommend a gradual increase in physical activity, with emphasis on aerobic exercise (exercise that raises your pulse and helps your heart relax). We also encourage a diet rich in fresh fruits, fresh vegetables and whole grains, and limited in sodium, fat and sugar-sweetened beverages.

Since excess salt can raise blood pressure, our dieticians often recommend that families focus on the amount of sodium they eat. Around 75 percent of excess salt comes from packaged and canned foods (and not from the salt shaker), simply switching from canned vegetables to frozen vegetables can help lower blood pressure.

We encourage aerobic exercise for almost all children with hypertension. Rarely, a child with severe hypertension may be restricted from specific activities. In these cases, restrictions may be lifted once the hypertension is adequately treated.

We emphasize the importance of family-wide commitment toward a healthy style. Since 90 percent of us will have hypertension by the time we're 80 years old just from normal aging, diet and lifestyle changes are important for everyone—not just children with high blood pressure.

Medication

Medication may be necessary to treat hypertension. Whether your child is prescribed medication for hypertension depends on a few things:

  • How high is her blood pressure?
  • How long has it been present?
  • Does it appear to be causing problems with her organs?
  • Has it responded to diet and exercise modification? If so, how well?

Sometimes, we treat a child with medication and changes in diet and exercise, in the hope that if she loses weight, we can take her off of the medicine. Once medication is started, they're monitored closely to determine if dose increases or decreases are required or if medication side effects occur.

Hypertension is a very wide-ranging disease. It can be difficult to predict what medicines a child will respond to, and how many medicines it will take to control a given child's blood pressure. If a child has chronic kidney disease or primary hypertension (in which case the doctor may not know what is causing the hypertension), it might take more than one medication to bring the blood pressure into a normal range for that child.

Remember–if your child's hypertension can't be controlled with diet and exercise alone, it's not a failure. It's important to keep exercising and eating healthfully. This is because exercise and healthy eating help to prevent a variety of other health problems.

If my child takes medication for hypertension, will she have to take it for the rest of her life?

Not necessarily. If there's an underlying cause for the hypertension and its treatment is successful, she may not have to stay on medication. If your child has primary hypertension, increased exercise and appropriate changes to her diet may allow her to be taken off of medication.

How do you treat infants with hypertension?

Infants may be treated with doses of liquid medication or with medicines given through an IV if they are hospitalized.

Premature infants sometimes have hypertension that starts right in the neonatal period or in the first couple months of life. We generally start these infants on medication to stabilize their hypertension. Some of these infants grow out of their hypertension and are able to stop medication when they are 1 to 2 years old.

What's the long-term outlook for my child?

Every child is different, but in general, the outlook for kids with hypertension is quite good. It can almost always be well-managed with medications and/or changes in diet and exercise.

We are grateful to have been ranked #1 on U.S. News & World Report's list of the best children's hospitals in the nation for the third year in a row, an honor we could not have achieved without the patients and families who inspire us to do our very best for them. Thanks to you, Boston Children's is a place where we can write the greatest children's stories ever told.”
- Sandra L. Fenwick, President and CEO

Boston Children's Hospital 300 Longwood Avenue, Boston, MA 02115 617-355-6000 | 800-355-7944

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