How to Prevent High Blood Pressure in Children

Almost half of Americans over 20 years old have hypertension. But what is not widely known is that hypertension, commonly known as high blood pressure, affects up to 6% of children and adolescents.

Blood pressure is the force of blood as it pushes against the artery walls. Arteries carry blood from your heart to other parts of the body. When the heart contracts and relaxes (beats), pressure is created inside the arteries. Systolic blood pressure is the force made as blood is pumped from the heart into the blood vessels. Diastolic blood pressure is when the heart is relaxed, which lowers the pressure in the arteries.

Hypertension occurs when the force of blood is too high within the arteries when the heart contracts or relaxes. If the arteries have an increased resistance, the heart will pump harder to circulate the blood to other body parts.

It’s normal for blood pressure to rise and fall throughout the day, but if it stays high for too long, it can damage your heart and cause health problems.

Childhood Hypertension

Childhood hypertension rates continue to rise, and over the last 30 years, rates have increased fourfold. A child's blood pressure is called elevated when it is at or is above the 90^th percentile compared to other children the same age, sex, and height over three or more visits.

Why Do Kids Have High Blood Pressure?

There are two classifications of pediatric hypertension. Primary hypertension is the most common type, and it is more prevalent among children who are overweight or obese and those with a family history of hypertension.

Secondary hypertension occurs in children with other health conditions, including:

• Congenital anomalies of the kidney and urinary tract
• Chronic kidney diseases
• Solid organ transplants and bone marrow transplants
• Narrowing of the aorta or kidney arteries
• Congenital heart diseases
• Endocrine disorders, including thyroid dysfunction and hormonal abnormalities
• Diabetic kidney disease
• Respiratory diseases such as obstructive sleep apnea and chronic lung diseases
• Genetic diseases
• Some medications

Why Do We Care?

Untreated high blood pressure in children may lead to complications later in life. Your child should have their blood pressure checked once a year at an annual health exam from the age of three. If your child has a condition that increases their risk for hypertension or has previously recorded a high blood pressure reading, their blood pressure will be checked every time they visit their primary care provider.

Risk Factors for Hypertension

Some of the risk factors for high blood pressure in kids include:

• Obesity
• Exposure to secondhand cigarette smoke
• Family history of high blood pressure
• High cholesterol or high triglycerides
• Sleep apnea
• Diabetes
• Premature birth or low birth weight
• Lack of exercise
• High salt intake
• High stress levels

It takes more than one blood pressure reading to diagnose hypertension. Blood pressure can be high if your child is stressed or unwell. Your doctor will check your child’s blood pressure, and if a high reading is recorded, they will check trends over time to see if high blood pressure is a pattern.

How to Prevent Primary Hypertension in Kids

If your child has primary hypertension, you can reduce their blood pressure through healthy lifestyle changes, which include:

• Exercise at least 30 minutes every day
• Maintain a healthy body weight
• Keep your child away from secondhand smoke
• Eat a well-balanced diet
• Avoid fried foods
• Reduce salt intake
• Avoid soda and sugary drinks
• Avoid foods with added sugar
• Limit screen time to under two hours each day
• Get 8-12 hours of sleep each day

A healthy lifestyle in childhood protects your child from hypertension and many chronic diseases.

How to Manage Secondary Hypertension

Secondary hypertension is caused by an underlying disease, so it is important to identify the cause. Once doctors have identified the source, they can find an effective way to treat the hypertension. Secondary hypertension often requires pharmacological therapy.

Symptoms of High Blood Pressure in Children

Untreated hypertension can cause complications related to damaged blood vessels and injury to the brain, kidneys, and heart. Most children with high blood pressure have no symptoms. There may be headaches, blurry vision, nose bleeds, or fatigue. Although children with hypertension rarely suffer a heart attack or stroke, many studies find that even young children develop accelerated hardening of the arteries, thickened heart walls, stiff vessels, kidney injury, and cognitive deficits.

Pediatric Kidney and Cardiovascular Health

“The prevalence of youth-onset hypertension is increasing, and hypertension in childhood tends to persist into adulthood, leading to cardiovascular disease,” explains Oklahoma Children’s Hospital OU Health pediatric nephrologist Dr. Ikuyo Yamaguchi, M.D., Ph.D., who leads the pediatric hypertension clinic at Oklahoma Children’s Hospital. “Diagnosing hypertension and providing the right treatment choices in early life is essential. Hypertension may coexist with other medical problems like obesity, high blood lipids, sleep apnea, and diabetes. It is vital to diagnose hypertension and provide the right treatment choices in early life. Ambulatory blood pressure monitoring has become a critical screening tool to evaluate blood pressure and distinguish white-coat hypertension from true sustained hypertension.

The pediatric hypertension clinic is a multidisciplinary team that includes pediatric nephrologists, nurses, dieticians, and social workers. The team collaborates with pediatric cardiology, interventional radiology, vascular surgery, transplant surgery, rheumatology, endocrinology, and other healthcare specialists to care for your children. The clinic offers evaluation, consultation, nutritional counseling, medication management, and diagnostic testing.

Learn more about our Pediatric Nephrology and Hypertension services and treatment, request an appointment or get a second opinion, or find out more about the pediatric nephrology team at OU Health by calling (405) 271-4211.