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More kids getting 'adult' disease

Increase in high blood pressure prompts pediatrics group to change guidelines


More children than ever have high blood pressure – but their parents don’t know it, experts are warning. Doctors are seeing kids even younger than 10 with dangerously high blood pressure, once considered an adults-only disease. Now the American Academy of Pediatrics (AAP) for the first time is issuing its first set of guidelines for treatment of high blood pressure in children and teens.

Consequently, the group has revised guidelines for the screening and treatment of hypertension in kids. An estimated 3.5 percent of children and teens have high blood pressure. Known as the “silent killer” because it demonstrates no visible symptoms, hypertension can have long-term consequences including heart disease, kidney disease and stroke, if left untreated.

Dr. Jennifer Squires, a pediatrician at Novant Health Elizabeth Pediatrics in Charlotte, said pediatricians are seeing more children with what were previously considered adult-type diseases including high blood pressure. “It’s scary because we’re now seeing children younger than 10 years old develop type 2 diabetes or hypertension,” she said. “For children that develop these diseases so early, their risk of complications greatly increases.”

Ideal blood pressure for children is different than that for adults. “For children, a normal blood pressure varies by age and height, for both boys and girls,” Squires said.  “For adolescents over 13 years old, a normal blood pressure is lower than 120 over 80, similar to that of adults, as recommended by the American Heart Association.”

The causes of high blood pressure in children are varied. Squires noted that hypertension is classified as either primary or secondary. “Primary hypertension is associated with being overweight or obese, or a family history of elevated blood pressure,” she said.  “Secondary hypertension is due to other sources, such as kidney disease, the narrowing of the aorta, adrenal or other endocrine disease, or medications,” she added.

The new guidelines include updated blood pressure tables based on normal-weight children for more precise classifications of high blood pressure in kids.  Previously, these tables included overweight and obese children, individuals with this condition tend to have higher blood pressure. By using new measurements, the blood pressure values will be lower than those issued in previous guidelines.

“Hypertension for children can cause detrimental health outcomes similar to complications experienced by adults, however, it can be more serious because they are experiencing complications at a much younger age,” Squires said. “The heart can become enlarged from having to work harder at pumping. Arteries become stiffer due to being stressed by the higher pressures.”

The academy recommended the following:

  • Have your pediatrician perform blood pressure measurements at routine screenings.

  • Hypertension can be managed with lifestyle changes such as more exercise and changing the child’s diet, but in some cases medication may be required to manage the condition.

Another change consists of confirming the diagnosis. Children tend to be concerned or fearful in the doctor’s office and their high blood pressure reading may reflect that fear. That is why the AAP recommends 24-hour ambulatory blood pressure monitoring.

Ambulatory blood pressure monitoring (ABPM) measures blood pressure as you move around, living your normal daily life. The testing is carried out over 24 hours using a small digital blood pressure machine that is attached to a belt around your body and which is connected to a cuff around your upper arm. ABPM allows a patient to proceed with everyday tasks and can even be left on at bedtime.

As a parent, there are things that you can do to prevent high blood pressure in your child. “It’s a simple plan, but not always the easiest to enact – exercise and healthy foods,” Squires said.  “For kids, active and creative play is really more important than a structured exercise routine. And we choose the foods we bring into the home, so make the right choice in the grocery store so our kids aren’t tempted.”





Published: 8/23/2017