What is normal blood pressure for children?
When the term "hypertension" (high blood pressure) is mentioned, it rarely comes to mind that it might affect young children. Unfortunately, this condition does not only affect adults; it can also affect children, especially with the rising rates of childhood obesity.
Pediatric hypertension is a health concern that can affect a child at any age. Often, high blood pressure is a secondary symptom indicating an underlying health issue.
Defining Pediatric Hypertension
The definition of high blood pressure in children differs from that in adults. It is defined as a blood pressure reading that remains elevated above 120/80 mmHg across three separate readings.
What is Blood Pressure?
Blood pressure is defined as the force that moves blood through the human circulatory system. It is vital because it delivers oxygen, nutrients, white blood cells, antibodies, and essential hormones, such as Insulin.
As the heart beats, it pumps blood throughout the body to provide the necessary energy and oxygen. When the heart muscle contracts, the blood pushes against the walls of the blood vessels; the force of this push is what we call "blood pressure." If the pressure is too high, it puts extra strain on the arteries and the heart, which may lead to serious complications like heart attacks and strokes.
Types of Hypertension in Children
Primary Hypertension: This occurs on its own, without an underlying medical condition.
Secondary Hypertension: This is caused by an underlying health condition and is the most common type found in younger children.
The prevalence of hypertension among children aged 3 to 18 years is 3.4%. High blood pressure during childhood often persists into adulthood. Furthermore, hypertension is considered one of the most serious conditions that can lead to death if treatment is neglected.
Hypotension in Children (Low Blood Pressure)
This condition occurs when a child’s blood pressure drops below the normal range, typically below 90/60 mmHg. It is classified into several types, the most significant of which are:
Neurally Mediated Hypotension (NMH): This occurs when a child stands for long periods. In most cases, it disappears as the child reaches adulthood.
Orthostatic Hypotension: This occurs during a sudden change in position, such as sitting up or standing up quickly. It usually resolves within a few seconds.
Severe Hypotension: This is a critical condition resulting from infections (sepsis), severe allergic reactions (anaphylaxis), or significant blood loss. It prevents oxygen from reaching the brain, causing serious symptoms that may lead to death.
Causes of Pediatric Hypertension
It is essential to identify the underlying cause of high blood pressure in children before starting treatment to ensure that any primary conditions are addressed. In young children, hypertension is often linked to the following health conditions:
Ÿ Premature birth (Preterm birth).
Ÿ Low birth weight.
Ÿ Congenital heart disease and certain kidney problems.
Ÿ Genetic conditions.
Ÿ Hormonal disorders.
Ÿ Hyperthyroidism (Overactive thyroid).
Ÿ Kidney diseases, such as Renal Artery Stenosis (narrowing of the kidney artery).
ŸCushing's Syndrome.
Ÿ Family history of hypertension.
Ÿ Obesity and an unhealthy lifestyle.
Ÿ Sleep disorders (such as sleep apnea).
In older children, especially those who are overweight, the exact cause of hypertension is often unknown (Essential Hypertension). Having high blood pressure at such a young age puts children at a higher risk of developing heart disease and strokes later in life.
Symptoms of Pediatric Hypertension
While most children with hypertension do not exhibit any symptoms, some may experience headaches and vision disturbances. In very rare cases, they may also suffer from chest pain.
Treatment of Hypertension in Children
Children diagnosed with high blood pressure do not necessarily have to live with the condition for life. Those who are not at a healthy weight can start by following a nutritious, healthy diet and becoming more physically active.
This can lower blood pressure by improving heart and blood vessel function, even for children within a healthy weight range.
Parents should offer fruits and vegetables as snacks and strictly limit salt (sodium), which is the primary culprit behind high blood pressure.
Guidelines recommend prescribing blood pressure medications if lifestyle changes are unsuccessful or if the child has an underlying medical condition. However, this is rare; medications are prescribed for only about 1% of children with hypertension.
If the underlying cause of high blood pressure is related to kidney, heart, or hormonal issues, those conditions must be treated first.
Prevention of Pediatric Hypertension
To ensure early detection and effective management of blood pressure issues, it is essential to:
Ÿ Measure blood pressure annually for children between 1 and 3 years old.
Ÿ Monitor blood pressure during every clinical visit for children who are obese, have pre-existing medical conditions, or are taking medications linked to high blood pressure.
Ÿ Maintaining normal blood pressure levels is vital for long-term health. If your child is diagnosed with hypertension, strictly follow the treatment plan recommended by your pediatrician.
Ÿ Adopting a balanced and nutritious dietary pattern.
Ÿ Dedicating time for outdoor play by visiting public parks and beaches.
Ÿ Encouraging consistent physical activity and sports.
Complications of Pediatric Hypertension
If left untreated, high blood pressure in children is likely to persist into adulthood. Children with chronic hypertension may develop thicker arteries as early as age 30.
If high blood pressure is not identified early, it may go undiagnosed for years, eventually leading to organ damage and other health issues, such as Acute Coronary Syndrome in adulthood. Common complications associated with pediatric hypertension include:
Ÿ Sleep Apnea: (Interruption of breathing during sleep).
Ÿ Stroke.
Ÿ Heart Attack.
Ÿ Heart Failure.
Ÿ Kidney Failure.
