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KIDS AND HYPERTENSION

When you think of high blood pressure, you classically think of adults. But hypertension in children is actually much more prevalent than it's commonly perceived. And because it often goes unrecognized, hypertension in children can lead to long term problems, like heart disease.

16 year old Kristina Stanton had the problem for years, but never realized its significance. “I remember when I was younger laying in bed and having this rushing sound in my ear. For a long time I didn’t know what to make of it,” recalls Kristina. Doctors told her it was just her being nervous at the doctor’s office. “My blood pressure was really high, about 180 over 104. It got higher throughout the day.”
Kristina says she was told it was no big deal. But it is a big deal. And that’s why the government has released new diagnosis and treatment guidelines for hypertension in children at the American Society of Hypertension’s annual scientific meeting. Dr. Bonita Falkner chaired the group that wrote the new guidelines. She says, “What’s recommended is that blood pressure be measured as part of regular healthcare in children starting at age three. We know that high blood pressure and some of the other contributors to heart disease have their seeds in childhood.”
Around 1 to 3 per cent of children have high blood pressure, which can lead to hypertension in children. Causes of high blood pressure include kidney problems, hormone problems, prematurity, and the more recent problem of obesity. Sean Levchuck, a pediatric cardiologist at St. Francis Hospital in New York, says, “We know that children with higher levels of blood pressure have a tendency to progress to hypertension. What might help is we follow these children a little more closely.”
High blood pressure in a child is diagnosed based on the age and height of the child. You can use rough guidelines- take 100 and add two times their age for the top number. It’s the upper number, the systolic number, that’s the big problem in kids. Ironically the systolic number is also the number that becomes a problem in old age. In between, among the youth and middle aged, it’s the lower number that goes up.
Experts suggest several guidelines for dealing with hypertension in children. These include identifying those children with weight problems and who are developing hypertension early, and putting them on regular exercise regimens, a restriction of sedentary activity, and a carefully monitored diet. Medications can be added if necessary. Children who are diagnosed with high blood pressure should undergo echocardiography to see if the heart is enlarged, the most prominent sign the blood pressure is doing damage to the cardiovascular system. The recommendations also say blood pressure should be treated starting with a single drug. In the long run, it will lessen the damage that high blood pressure can cause over time, and lessen the risk of coronary artery disease and stroke.
And the short run benefits of treating hypertension in children are great. Kristina is ecstatic over the effect of the medicine. “Once I took the medicine I realized the difference in just how much better I felt. It’s a big difference. I don’t ever want to feel that way again, now that I know what it’s like to feel normal,” exclaims Kristina.

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