High Blood Pressure in Children
Did I hear someone ask “Why should Children ever be plagued with high blood pressure?
Well, high blood pressure although more common in adults, may also occur in children, and this could be caused by problems with the heart or kidneys. A lot of children have very poor lifestyle habits which could predispose them to high blood pressure at their tender age. These poor lifestyle habits include unhealthy eating, lack of exercise. A nmuber of them are also overweight and obese.
As we can see these aforementioned lifestyle habits are some of the controllable risk factors mentioned in chapter 3. We would be going into details about causes of high blood pressure in children so as to be enlightened and also for proper understanding.
Let us note that by children we are talking about people between the age range of newborns and 18 years of age. Based on the ages of children, neonates (newborns) or children less than 6 years of age usually develop high blood pressure as a result of an underlying disease known as secondary high blood pressure. It is commonly caused by problems with the kidneys.
Starting from age seven (7), essential high blood pressure (hypertension of unknown causes) starts to appear but it is still relatively rare. In this age group hypertension due to obesity is very common. By age 11, children have more of essential hypertension and cases begin to look more like adult cases.
The important thing to note is that there is no specific value for blood pressure in children as it differs from one age group to another. Therefore it is difficult to say if a child’s blood pressure is normal. Measuring blood pressure in children can be quite challenging depending on the age of the child as smaller children would most definitely not welcome a stranger strapping a cuff to his/her arm or squeezing an instrument on his/her arm.
This notwithstanding, a proper technique of measuring blood pressure in children must be followed in order to avoid a wrong diagnosis. The following are some guidelines in achieving proper blood pressure measurements in children.
- The proper cuff size must be selected, with the width of the cuff being appropriate for the size of the child’s arm. It has to encompass the upper arm completely and the length of the bladder must cover at least 80% of the upper arm circumference and the width should also be 40% of the distance between the elbow and shoulder.
- The baby should not be crying or sucking while taking blood pressure measurements. He / she should rather be lying down quietly.
- The child should be made familiar with the environment (that is the examination room) to ensure they are calm before a blood pressure reading is taken.
- The arm should be at the same level with the heart in any position the blood pressure reading is taken. i.e sitting or lying.
- In the presence of an elevated blood pressure, the doctor shluld measure the blood pressure in both arms and legs on the same visit.
Remember I said earlier in this chapter that there is no specific normal value for blood pressure in children unlike adults as blood pressure in children vary from one age to another. Below is a table showing the maximum normal blood pressure in children at different ages.
|New born||70 / 45 mmHg|
|1 to 5 years||115 / 75 mmHg|
|6 to 12 years||125 / 80 mmHg|
|13 to 15 years||126 / 78 mmHg|
|16 to 18 years||132 / 82 mmHg|
|over 18 years||139 / 89 mmHg|
NB: A child’s height can affect blood pressure a taller child might have a higher blood pressure than a shorter child of them same age. Many teenagers with high blood pressure usually do not have other health problems. The cause of hypertension is probably due to a family history of hypertension and an unhealthy lifestyle.
Unhealthy lifestyle stated above usually encompasses excess weight, too little physical activity, stress and a bad diet. The younger the child the more likely the hypertension is linked to an illness.
What causes hypertension in Children?
Like was said earlier, the causes of hypertension in children differs from one age group to another. In infants (Children under 1 year) high blood pressure occurs as a result of Heart, lungs, Kidney and circulation problems. Most times these babies have such problems as a result of prematurity.
In teenagers however hypertension is caused by obesity or excess weight. In very few cases however, hypertension could be caused by abnormalities in the blood vessels and hormonal disorders. There are some medications also that could predispose to high blood pressure such as cocaine, steroids and even alcohol. These should be avoided in little children.
When the cause of hypertension cannot be identified and all other causes have been ruled out, hypertension is said to be “essential hypertension”. Now that we have identified some of the causes of childhood hypertension a few measures can be taken to avoid high blood pressure in children. Of course we know we cannot alter family history as a cause of hypertension but we can work on the other factors associated with an unhealthy lifestyle.
It is very neccessary to discuss the various measures to prevent and manage hypertension in children to avoid dangerous and serious consequences. Drugs can be used to manage hypertension, and this approach is known as pharmacologic approach. The use of drugs to treat hypertension is essential in some cases depending on the cause of hypertension.
However there is another approach to managing hypertension known as the non-pharmacologic approach. This approach also doubles in preventing hypertension in children who do not have hypertension yet but have very high risk factors. Iit simply involves lifestyle modification. Here are some simple and effective non – pharmacologic ways of preventing hypertension.
- Eating healthy: It is important to follow a healthy diet low in fats and encourage consumption of vegetables and fruits as this helps to reduce blood pressure in overweight and prevent more weight gain
- Weight loss: An overweight child should be encouraged to loose reasonable weight of course by eating healthy and exercising. It should be noted that although weight loss is important for an overweight child, the child should not be deprived completely of pleasurable eating (ie ice cream, biscuits etc) all in the name of weight loss.A little treat occasionally is advisable
- Exercising: The beneficial effects of exercise cannot be overemphasized. It works in conjunction with healthy eating to help maintain normal weight in children and preventing obesity.
- Reducing Salt intake: As we have discovered in previous chapters, too much salt in the diet is one of the risk factors of high blood pressure and as such should be considerably reduced. Likewise diets rich in potassium such as Carrots, spinach, tomatoes, bananas, oranges should be encouraged as they help to reduce high blood pressure.
- Avoiding Stress: Finally if it is noted that hypertension is stress induced it should be properly addressed by avioding stressful conditions and reducing it to the barest minimum