High blood pressure (hypertension) in children is blood pressure that is at or above the 95th percentile for children who are the same sex, age and height as your child. There isn't a simple target range for high blood pressure in all children because what's considered normal changes as children grow. However, in teenagers, high blood pressure is defined the same as for adults: A blood pressure reading greater than or equal to 130/80 millimeters of mercury (mm Hg).
The younger a child is, the more likely it is that the high blood pressure is caused by a specific and identifiable medical condition. Older children can develop high blood pressure for the same reasons adults do — excess weight, poor nutrition and lack of exercise.
Lifestyle changes, such as eating a heart-healthy diet low in salt (sodium) and exercising more, can help reduce high blood pressure in children. But for some children, medications may be necessary.
High blood pressure usually doesn't cause symptoms. However, signs and symptoms that might indicate a high blood pressure emergency (hypertensive crisis) include:
If your child has any of these signs or symptoms, seek emergency medical care.
Your child's blood pressure should be checked during routine well-check appointments starting at age 3, and at every appointment if your child is found to have high blood pressure.
If your child has a condition that can increase the risk of high blood pressure — including premature birth, low birth weight, congenital heart disease and certain kidney problems — blood pressure checks might begin soon after birth.
If you're concerned about your child having a risk factor for high blood pressure, such as having obesity, talk to your child's doctor.
High blood pressure in younger children is often related to other health conditions, such as heart defects, kidney disease, genetic conditions or hormonal disorders. Older children — especially those who are overweight — are more likely to have primary hypertension. This type of high blood pressure occurs on its own, without an underlying condition.
Your child's risk factors for high blood pressure depend on health conditions, genetics and lifestyle factors.
Primary hypertension occurs on its own, without an identifiable cause. This type of high blood pressure occurs more often in children age 6 and older. The risk factors for developing primary hypertension include:
Secondary hypertension is caused by another condition. It's more common in young children. Other causes of high blood pressure include:
Children who have high blood pressure are likely to continue to have high blood pressure as adults unless they begin treatment.
If your child's high blood pressure continues into adulthood, your child could be at risk of:
High blood pressure can be prevented in children by making the same lifestyle changes that can help treat it — controlling your child's weight, providing a healthy diet low in salt (sodium) and encouraging your child to exercise.
High blood pressure caused by another condition can sometimes be controlled, or even prevented, by managing the condition that's causing it.
The doctor will perform a physical exam and ask questions about your child's medical history, family history of high blood pressure, and nutrition and activity level.
Your child's blood pressure will be measured. The correct blood pressure cuff size is important for measuring accurately. It is also important that blood pressure be measured with proper technique, in a quiet environment, with the child resting comfortably. During a single visit, your child's blood pressure might be measured two or more times for accuracy.
For a diagnosis of high blood pressure, your child's blood pressure must be higher than normal when measured during at least three visits to the doctor.
If your child is diagnosed with high blood pressure, it's important to determine whether it's primary or secondary. These tests might be used to look for another condition that could be causing your child's high blood pressure:
To confirm a diagnosis of high blood pressure, your child's doctor might recommend ambulatory monitoring. This involves your child temporarily wearing a device that measures blood pressure throughout the day, including during sleep and various activities.
Ambulatory monitoring can help rule out blood pressure that's temporarily raised because your child is nervous at the doctor's office (white-coat hypertension).
If your child is diagnosed with slightly or moderately high blood pressure (stage 1 hypertension), your child's doctor will likely suggest trying lifestyle changes, such as a heart-healthy diet and more exercise, before prescribing medications.
If lifestyle changes don't help, your child's doctor might recommend blood pressure medication.
If your child is diagnosed with severely high blood pressure (stage 2 hypertension), your child's doctor will likely recommend blood pressure medications.
Medications might include:
Your child's doctor will tell you how long your child will need to stay on the medication. If your child's high blood pressure is caused by obesity, losing weight might make medication unnecessary. Treating other medical conditions your child has might also control his or her blood pressure.
Although little is known about the long-term effects of blood pressure medication on a child's growth and development, many of these medications are generally considered safe to take during childhood.
High blood pressure is treated similarly in children and adults, usually starting with lifestyle changes. Even if your child takes medication for high blood pressure, lifestyle changes can make the medication work better.
Decrease salt in your child's diet. Cutting the amount of salt (sodium) in your child's diet will help lower his or her blood pressure. Children ages 2 to 3 shouldn't have more than 1,200 milligrams (mg) of sodium a day, and older children shouldn't have more than 1,500 mg a day.
Limit processed foods, which are often high in sodium, and limit eating at fast-food restaurants, whose menu items are full of salt, fat and calories.
Your child's blood pressure will be checked as part of a routine complete physical exam or during any pediatric doctor appointment when indicated. Before a blood pressure check, make sure your child hasn't had caffeine or another simulant.
Make a list of:
For high blood pressure, questions to ask your doctor include:
Don't hesitate to ask other questions.
Your child's doctor is likely to ask you questions, such as:
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