Pediatric Hypertension

So grandma’s blood pressure is 122/85 and the doctor tells her that’s great, but when your 3-year old comes in with the same blood pressure we tell you it’s too high...

In fact we tell you that same blood pressure is higher than 99% of children the same age, sex, and height as your child… how is that possible?

Blood pressure naturally elevates as we age, so we expect lower blood pressures the younger the child. For example, 50% of one year old boys have blood pressure around 85/37.

What is elevated blood pressure (or hypertension)?

The definition of hypertension in children is based on a normal distribution of blood pressures in healthy children. When we evaluate blood pressure we compare to other children of the same age, sex, and height.

Your child is considered to have hypertension when their blood pressure (systolic – top number or diastolic – bottom number) is greater than the 95% of those children on 3 separate occasions.

We begin checking blood pressure at your child’s 3 year well-visit, or sooner if risk factors are present. We check with every well-visit after that, along with every sick-visit if risk factors are present or high blood pressure has been noted before.

After hypertension is confirmed in your child we will draw some labs in the office to determine if there is an underlying reason for the elevation in BP.

What causes hypertension?

  • Certain disease put a child at risk, such as:
    • Kidney diseases
    • Prematurity (or low birth weight infants)
    • Genetic conditions
  • Certain medications
  • Obesity
  • Family history of hypertension

Why do we care?

Hypertension is a “silent” disease, meaning your child may not experience symptoms to alert you something is wrong. He may continue on with daily routines without any changes. Hypertension is a significant pre-disposing factor for heart disease and stroke, especially going into adulthood.

Combined with obesity, hypertension is linked to type II diabetes and sleep apnea.

What can I do?

Lifestyle modifications are the number one treatment:

  • Weight reduction for obesity-related hypertension
  • Increase regular physical exercise
    • Decrease sedentary activities to less than 2 hours per day. These include watching television, playing video games, and playing computer games.
  • Dietary modifications
    • Decrease sugary drinks (juice, soda, sweet tea, etc.), decrease foods high in salt, increase fruits and vegetables, increase water consumption, and encourage portion control.
      • Heart-healthy options
        • Green leafy vegetables: spinach, collard greens, romaine lettuce
        • Blueberries, strawberries, raspberries
        • Baked potato (plain)
        • Skim milk
        • Oatmeal
        • Bananas and apples (most fruit)
        • Skin-less poultry and fish
        • Nuts and legumes
        • Whole-grains
        • Other vegetables including: broccoli, carrots, squash
        • WATER                            
      • Limit
        • Sugary drinks: juice, soda, tea
        • Red meat
        • Fried foods
        • Salty foods: French fries, bacon, sausage, pickles
        • Whole milk (unless under 2 or otherwise advised to)
        • Ramen noodles
        • Alcohol
        • Tobacco
        • Sweet desserts

Medications may be given to your child by provider discretion. Compliance with these medications is very important. Remember your child won’t necessarily “feel better” since this is a “silent” disease, but disease management remains important for the future of your child’s health.