High blood pressure in children
High blood pressure in childrenArticle Sections
DefinitionHigh blood pressure (hypertension) in children is blood pressure that's the same as or higher than 95 percent of children who are the same sex, age and height as your child. There isn't a simple target blood pressure reading that indicates high blood pressure in children, because what's considered normal blood pressure changes as children grow. High blood pressure in children younger than 10 years old is usually caused by another medical condition. High blood pressure in children can also develop for the same reasons it does in adults — being overweight, eating a poor diet and not exercising. Lifestyle changes, such as eating a heart-healthy diet and exercising more, can help reduce high blood pressure in children. But, for some children, medications may be necessary. SymptomsHigh blood pressure doesn't often cause symptoms, though some children with high blood pressure may experience headaches.
Severe high blood pressure
When to see a doctor 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 urinary or kidney problems — blood pressure checks may begin during infancy. If you're concerned about your child having a risk factor for high blood pressure, such as being overweight or obese, talk to your child's doctor. He or she may recommend more frequent blood pressure checks. CausesHigh blood pressure in younger children is often related to other health conditions such as heart defects, kidney disease, genetic conditions or hormonal disorders. In older children — especially those who are overweight — the precise cause of high blood pressure is often unknown. Risk factorsYour child's risk factors for high blood pressure depend on underlying health conditions, genetics or lifestyle factors.
Secondary high blood pressure
Essential, or primary, hypertension
ComplicationsChildren who have high blood pressure are likely to continue to have high blood pressure as adults unless they begin treatment. A common complication associated with high blood pressure in children is sleep apnea, a condition in which your child may snore or have abnormal breathing when he or she sleeps. Pay attention to breathing problems your child may have while sleeping. Children who have sleep-disordered breathing, such as sleep apnea, often have problems with high blood pressure — particularly children who are overweight. If, as often happens, your child's high blood pressure persists into adulthood, your child could be at risk of:
Preparing for your appointmentThere are no special preparations necessary for your child's blood pressure to be checked. Your child's blood pressure will likely be checked as part of a routine doctor's appointment. If you have concerns about how often your child's blood pressure is being checked, talk to your child's doctor. Tests and diagnosisThe test for high blood pressure is painless. Blood pressure is measured with an inflatable arm cuff and a pressure-measuring gauge. The cuff size used will vary with your child's arm circumference and any growth that has occurred. Your child may feel a tight squeeze around the arm when the cuff is inflated. You can find out what your child's blood pressure is immediately after the test is over. A blood pressure reading has two numbers. The first, or upper, number measures the pressure in your child's arteries when his or her heart beats (systolic pressure). The second, or lower, number measures the pressure in your child's arteries between beats (diastolic pressure). Normal blood pressure readings in children vary based on sex, age and height, so what may be a high blood pressure reading for a 4-year-old boy may be normal for a 10-year-old girl. Your child's doctor will let you know if your child's blood pressure readings are elevated. Your child won't be diagnosed with high blood pressure after only one blood pressure measurement. To diagnose high blood pressure, it takes three measurements that show your child's blood pressure is higher than normal over the course of at least three visits to the doctor. If your child's blood pressure is higher than normal, it should be checked about every six months after high blood pressure is first diagnosed. If your child is diagnosed with prehypertension or hypertension, your child's doctor may also perform these tests to see if another condition is causing your child's high blood pressure:
If your child's doctor is having difficulty diagnosing high blood pressure, or wants to monitor your child's treatment, he or she may recommend ambulatory monitoring. In ambulatory monitoring, your child wears a device that measures his or her blood pressure throughout the day. This is not yet common practice, and more research is necessary to see if ambulatory monitoring helps in the treatment and diagnosis of high blood pressure in children. However, ambulatory monitoring may be especially helpful if your child is normally quite nervous at the doctor's office, because he or she may have what's known as white-coat hypertension — blood pressure that's only temporarily elevated due to anxiety from being at the doctor's office. Treatments and drugsLifestyle changes, including a heart-healthy diet and exercise, are often the first approach your child's doctor will recommend to lower your child's blood pressure. If your child is diagnosed with slightly or moderately high blood pressure (prehypertension or 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 your child's blood pressure doesn't decrease after trying lifestyle changes, your child's doctor may 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. These medications may include:
Your child may need blood pressure medications temporarily or indefinitely. If your child's high blood pressure is caused by obesity, losing weight may eliminate the need for medication. In other cases, treating other medical conditions your child has might 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. Depending on the specific drug, side effects are possible, including dry mouth, dizziness and fatigue. Lifestyle and home remediesHigh blood pressure is treated similarly in children and adults, typically starting with lifestyle changes.
PreventionHigh blood pressure caused by another condition can sometimes be controlled, or even prevented, by effectively managing the underlying condition. Essential 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 and encouraging your child to exercise. RelatedLast Updated: 2010-08-19 © 1998-2013 Mayo Foundation for Medical Education and Research (MFMER). All rights reserved. A single copy of these materials may be reprinted for noncommercial personal use only. "Mayo," "Mayo Clinic," "MayoClinic.com," "Mayo Clinic Health Information," "Reliable information for a healthier life" and the triple-shield Mayo logo are trademarks of Mayo Foundation for Medical Education and Research.
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