Hypertension in Children

by admin-blog-kh | July 4, 2024 9:30 am

Summary

Hypertension in children is on the rise. It is usually caused due to kidney disease, congenital heart problems or other underlying conditions, but can also be caused due to lifestyle factors like obesity, exposure to second-hand smoke and stress. Hypertension in children must be diagnosed in a more rigorous manner, with multiple readings over time, to avoid misdiagnosis. Hypertension in children could present as headaches, seizures, vomiting, chest pains and heart palpitations[1]. If your child experiences any of these symptoms, seek urgent medical help. Hypertension in children is typically treated using a combination of lifestyle changes and medication. The long-term outlook for paediatric hypertension is good if the child is given adequate support and follows their treatment plan correctly.

Introduction

Hypertension, or high blood pressure, is associated with adults who are stressed, sedentary and unhealthy. However, studies now reveal a shocking fact – Children can suffer from hypertension too! This revelation has challenged our established ideas about hypertension and its causes, as well as paediatric health[2]. Alarming trends indicate that hypertension in children is on the rise. We have a crisis on our hands as a society and it begs the question – Why? In this article we will explore the causes and implications of hypertension in children, and the preventative measures we can take to safeguard the health of future generations.

A child is diagnosed with high blood pressure if their average blood pressure is at or above the 95th percentile for their age, sex and height. This is usually measured multiple times, over 3 visits or more, to eliminate measurement error and anomalies. The normal range of blood pressure in children increases with age, so there isn’t a simple benchmark to measure hypertension against. However, in teenagers, high blood pressure is defined the same way it is for adults – A blood pressure reading above 130/80 mm Hg is considered high. Younger children are more likely to experience hypertension that is induced by a medical condition. Slightly older children could have underlying medical conditions but they could also be experiencing hypertension due to lifestyle factors like stress, poor diet and a lack of exercise.

Symptoms of Hypertension in Children

High blood pressure in children could cause one or more of the following symptoms:

• Headaches
• Seizures
• Vomiting
• Chest Pains
• Quick, uneven heart beats (Heart Palpitations)
• Shortness of breath

If your child has any of these symptoms, please take them to the child doctor[3] for further investigation.

Causes of Hypertension in Children

There are 2 types of Paediatric Hypertension:

1. Primary hypertension – Primary hypertension is high blood pressure that doesn’t have a distinct cause. It’s also called idiopathic hypertension for this reason. Children with primary hypertension usually have the following characteristics:

• Older than 6 years
• Have a family history of hypertension
• Having a high body mass index

2. Secondary hypertension – This type of hypertension has a clear underlying cause. A majority of secondary hypertension cases are caused by kidney disease. This includes conditions like glomerulonephritis, reflux nephropathy, pyelonephritis and polycystic kidney disease. Other causes of secondary hypertension in children could be congenital heart conditions, hormonal imbalances, obstructive sleep apnea and genetic mutations. Certain medications can also cause high blood pressure as an undesirable side effect. Environmental exposure to lead, cadmium or mercury also cause an elevated blood pressure.

Risk Factors for Hypertension in Children

Children who satisfy these criteria are at a higher risk of developing hypertension:

• Overweight – Increased body fat puts children at a higher risk of hypertension. Excess body weight requires the heart to pump blood with greater force to circulate it effectively. Over time this leads to excess cardiac output and causes elevated blood pressure.
• Family History – Genetics has an effect on blood pressure. If one or more close biological relatives has hypertension before the age of 60, that increases the child’s risk of developing it as well.
• High-sodium diet – A diet rich in processed or preserved foods can cause an excess of sodium in the blood stream. This makes the body retain water more, leading to elevated blood pressure.
• Lack of exercise – Regular physical activity strengthens the heart, and allows it to pump blood throughout the body more efficiently. If your child does not have a physically active lifestyle, their heart could struggle to pump blood, leading to elevated blood pressure.
• Diabetes – Children with diabetes[5], or high blood sugar levels, have a higher chance of developing hypertension.
• Pre-term babies and low birth-weight babies – Children who are born pre-term and with low birth weight have a higher risk of childhood hypertension.
• Children who are exposed to tobacco products, either in-utero, or in infancy and childhood have a higher risk of hypertension.

In children who have these risk factors, doctors are likely to begin screening for high blood pressure from infancy. If the child doesn’t have any of these risk factors, they may do routine blood pressure readings at annual check-ups, and only investigate further if the initial results are found to be high.

Diagnosis of Hypertension in Children

Hypertension in children is not diagnosed the same way as it is done in adults. In children, the blood pressure changes as they grow so the threshold for “high” blood pressure in children is not exactly fixed. The child’s blood pressure readings are compared to the average blood pressure of their same-age peers. Multiple readings must be taken to ensure there is no error in measurement, or any other operational anomaly. The stress of being in a pediatric doctor’s office, and the tension the parent feels at their child’s physical condition itself can cause elevated stress levels in the child. The doctor must feel convinced beyond any doubt that external environmental factors are not contributing to the child’s elevated blood pressure.

To check a child’s blood pressure, the doctor will wrap a cuff called a sphygmomanometer around the child’s arm and place a stethoscope below it. The cuff is then pumped full of air. The reading is measured as the air is slowly released from the cuff.

Once hypertension has been diagnosed, the doctor will then begin investigating the cause of the elevated blood pressure. This is vital, as treatment methods are dependent on the underlying condition causing the hypertension. This could include a panel of kidney function tests, urine tests, blood tests, ECGs, renal ultrasound scans and any other tests the doctor deems necessary for diagnostics.

Treatment of Hypertension in Children

The treatment plan for hypertension in a child has to be tailored to suit the patient’s unique case. Typically, treatment will target the underlying cause of the hypertension. The approach taken is usually a combination of lifestyle changes and medication.

Since being overweight is such a big risk factor for hypertension in children, it’s one of the first things that the treatment plan will attempt to tackle. The patient is recommended a balanced diet rich in fruits, vegetables, whole grains and lean protein. They must avoid foods that are high in trans fats and saturated fats. Processed foods which are too salty, too sugary and high in preservatives are also to be avoided. The patient must also make it a habit to be more physically active. Children suffering from hypertension need to prioritise spending time outside, running around and playing with their friends over passive screen time spent indoors. If the child is interested, they can take up a sport, or learn dance. The healthy diet and physical exercise introduced into the child’s routine work together to simultaneously help the child lose their excess weight and de-stress.

In many cases, lifestyle changes alone are not enough to bring down the elevated blood pressure. Medication is then recommended to bring it down. Commonly prescribed medication for hypertension in children includes:

• Angiotensin-converting enzyme (ACE) inhibitors
• Angiotensin II receptor blockers (ARBs)
• Calcium channel blockers
• Beta-blockers
• Diuretics

If the hypertension is caused due to an underlying kidney disease, the child will be prescribed medication and other treatments for that as well.

Children with hypertension require regular monitoring, even while they are being treated. Their blood pressure needs to be monitored regularly to ensure the treatment is working. The doctor needs regular blood pressure data to assess and adjust dosages of the medication. The patient’s primary caregiver must educate themselves about their child’s condition and effectively monitor their symptoms for the best outcome.

Long-term Outlook for Children with Hypertension

For most patients with paediatric hypertension, lifestyle changes and medication work well in bringing down the elevated blood pressure to manageable levels. This is subject to early diagnosis, good treatment protocols and regular monitoring by the primary care giver and the pediatric doctor[6]. The condition may never be “cured” but with the right support it can be managed well for the rest of their lives.

If left untreated, the condition can be very dangerous and can lead to further complications including heart attacks, heart failure, kidney failure and strokes.

Prevention of Hypertension in Children

Hypertension in children is an unfortunate reality for many, but here are some tips to prevent hypertension in your child:

• Maintain a weight that’s healthy for your child. This is based on their age, gender and height. You can speak to your doctor about what a healthy weight range is for your child.
• Feed them healthy, whole foods. A diet high in salt, sugar and fats is known to cause hypertension so try to avoid that. Eating lots of processed or preserved foods should be avoided. Swap out your child’s sugary snacks for fruits and vegetables, and introduce some high-protein options as well. Food cooked at home with love is always the best 🙂
• Keep them active. Your child doesn’t need to go to the gym; They just need to go out and play. Keep them moving, so they don’t become sedentary. They key to this is cutting their screen time, and taking them outside.
• Encourage your child to have a healthy sleep routine. Don’t let them stay up late in the night. Children need almost 10 hours of sleep.
• Do not expose your child to second hand smoke or tobacco products. Smoking and vaping increase blood pressure, so this should be avoided at all costs.

Ensure your child’s health is in professional hands. Kauvery Hospital is equipped with leading-edge medical technology and experienced paediatric doctors, ready to diagnose and treat a range of illnesses including hypertension in children. With branches located across Chennai, Hosur, Salem, Tirunelveli, and Trichy, we are dedicated to providing top-tier medical care for your little ones. Get in touch with us today. Your child’s health is our top priority.

Frequently Asked Questions

What are the symptoms of hypertension in children?

Hypertension[8] in children can cause headaches, seizures, vomiting, chest pains, heart palpitations, and shortness of breath.

What causes hypertension in children?

Hypertension in children can be caused by kidney disease, congenital heart problems, obesity, second-hand smoke exposure, and stress.

How is hypertension diagnosed in children?

Hypertension in children is diagnosed through multiple blood pressure readings over time, compared to average values for their age, sex, and height.

What treatments are available for children with hypertension?

Treatment includes lifestyle changes, such as a healthy diet and regular exercise, and medications like ACE inhibitors, ARBs, calcium channel blockers, beta-blockers, and diuretics.

How can I prevent hypertension in my child?

Prevent hypertension by maintaining a healthy weight, providing a balanced diet, encouraging physical activity, ensuring good sleep habits, and avoiding exposure to tobacco smoke.

What is the long-term outlook for children with hypertension?

With early diagnosis, proper treatment, and regular monitoring, children with hypertension can manage their condition effectively and lead healthy lives.

Kauvery Hospital is globally known for its multidisciplinary services at all its Centers of Excellence, and for its comprehensive, Avant-Grade technology, especially in diagnostics and remedial care in heart diseases, transplantation, vascular and neurosciences medicine. Located in the heart of Trichy (Tennur, Royal Road and Alexandria Road (Cantonment), Chennai (Alwarpet & Vadapalani), Hosur, Salem, Tirunelveli and Bengaluru, the hospital also renders adult and pediatric trauma care.

Chennai Alwarpet – 044 4000 6000 •  Chennai Vadapalani – 044 4000 6000 • Trichy – Cantonment – 0431 4077777 • Trichy – Heartcity – 0431 4003500 • Trichy – Tennur – 0431 4022555 • Hosur – 04344 272727 • Salem – 0427 2677777 • Tirunelveli – 0462 4006000 • Bengaluru – 080 6801 6801

Source URL: https://www.kauveryhospital.com/blog/paediatrics/hypertension-in-children/

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