Dr. Gellner: We usually think of high blood pressure as an adult problem. But did you know that kids can get it too?
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Dr. Gellner: High blood pressure or hypertension is something adults deal with all the time. However, an estimated 3.5% of all kids in the U.S. have it too. It often goes undetected and thus untreated. Sometimes it goes undiagnosed for years and can lead to problems like coronary artery disease in adulthood. To try to identify more about blood pressure issues in children, the American Academy of Pediatrics recently came up with a report to give pediatricians a simple screening table to follow to figure out when a child's blood pressure needs further evaluation.
First, let me explain what blood pressure is. It's actually two separate measurements. The systolic blood pressure is the highest pressure reached in the arteries as the heart pumps blood out to the body. And the diastolic blood pressure is the lower pressure from the arteries when the heart relaxes between beats, so it can take in blood coming back from the body. If either or both measurements are high, that's hypertension.
In kids, it's tricky to diagnose hypertension because the ranges change based on height, age, and if they're a boy or a girl. Also, if a child is in pain or has a fever, it might be high. But we are more concerned about what their blood pressure is when they are healthy. That gives us our best measurement.
We start doing blood pressures when a child is three, usually at their three-year-old well-child visit. If your child's blood pressure is indeed high, we have you come back for a recheck in about a week. If they have high readings for three consecutive visits, that's when red flags start popping up for us pediatricians, and we need to evaluate further.
Most kids don't have any symptoms when their blood pressure is high. For most kids, especially after age seven, more than 50% of hypertension in kids is due to obesity. That rises to 85% to 95% in teens. The treatment for hypertension due to obesity is the same for kids and adults --healthier eating, lower salt diets, and plenty of physical activity.
Usually, if hypertension in child is due to another cause, such as kidney disease or hormone problem, your child will have other symptoms that your pediatrician will be able to pick up on quickly with blood or urine tests. In these cases, your pediatrician will refer your child to a specialist who can manage the underlying cause and that will help manage the hypertension. So, if you have a family history of high blood pressure, or your child is over three and your child's blood pressure isn't taken at the well-child visit, speak up and ask your pediatrician to check it. This isn't something you want to miss.
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