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Children need regular screening for high blood pressure

February 05, 2018 | UC Irvine Health
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Pediatricians should routinely screen children for high blood pressure during well-child exams. That’s the recommendation of the American Academy of Pediatrics (APA), which recently issued its first-ever guidelines on the topic.

Hypertension in children rarely caught

While the condition is more prevalent in adults, an estimated 3.5 percent of children and adolescents have high blood pressure, also called hypertension. Yet few cases are caught. In fact, the diagnosis is missed in about three out of every four cases in primary care settings, according to the APA.

The problem is two-fold: Children with hypertension seldom show symptoms and not all pediatricians routinely screen for blood pressure. But as U.S. children in general are increasingly becoming overweight, elevated blood pressure is also on the rise.

“There’s been a dramatic increase in the incidence of obesity, so we’re seeing more cases of hypertension as a result,” says Dr. James P. Morley, a board-certified UCI Health pediatrician.

High blood pressure goes right along with obesity,” says Morley, who emphasizes preventive care and good nutrition in his Tustin pediatrics practice.

Other causes of high blood pressure

Sometimes, a medical condition may cause hypertension in children.

For example, heart defects, kidney disease and hormone disorders can all elevate blood pressure levels.

A family history of hypertension also increases risk.

Morley notes that it can be challenging to get accurate blood pressure readings in children. They may feel anxious or upset during a doctor visit, which can also elevate blood pressure levels temporarily. For children — and even adults — the doctor will want to take multiple readings at different times before coming to any conclusions.

Childhood hypertension linked to adult problems

Why is high blood pressure a concern?

  • Hypertension in children can damage the heart and kidneys, and it is also associated with high cholesterol and diabetes.
  • Children with hypertension may also snore or have abnormal breathing during sleep, a condition called sleep apnea.
  • Most important, children with high blood pressure tend to carry the condition into adulthood. That increases their risk of stroke, heart attack, heart failure and kidney disease.

How to treat high blood pressure

Once a child is found to have high blood pressure, his or her doctor will try to determine the cause.

“Because the damage from hypertension or its underlying cause is cumulative, the earlier you can identify and correct it, the better,” says Morley.

If lifestyle changes don’t decrease blood pressure levels, blood pressure-lowering medication may be prescribed.

The key to prevention

As with treatment, prevention involves nutrition and exercise.

“At the end of the day, a truly healthy diet and active lifestyle is preventive for lots of problems, not just elevated blood pressure,” says Morley.

“As children grow up, these healthy lifestyle behaviors will promote their general health beyond blood pressure, particularly in decreasing the risk of diabetes and cardiovascular disease,” he adds.

“Children get used to whatever patterns the family sets. So starting them on healthy habits early will have a long-lasting positive effect.”

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