How often should we check blood pressure?
All children over 3 years old should have their blood pressure measured during their routine checkup once a year. Blood pressure measurements should be measured in younger children who have kidney or heart disease.
Can anything make blood pressure look higher than it really is?
There are a multiple reasons why your child’s blood pressure could be measured higher than it really is. Checking for these things during measurement can make sure that the blood pressure that is read is the real pressure.
- The blood pressure should not be measured if the child is crying or unable to cooperate.
- An appropriate-size cuff should be used. A cuff that is too small can overestimate the pressure.
- Caffeine can raise blood pressure even if taken several hours before measurement.
- "White coat" hypertension is the name given to high blood pressure caused by anxiety in the pediatrician’s office. If your child is always very nervous about coming to the doctor, you might consider measuring their blood pressure outside of the doctor’s office to see if it is lower.
Does all high blood pressure have the same cause?
No, there are two different categories for high blood pressure.
Primary hypertension — also called essential hypertension, has no identifiable cause. It is the most common cause of high blood pressure in older children. It is more common in kids who:
- Have completed puberty
- Someone else in the family has high blood pressure
- Are overweight or obese
- Have only mildly high blood pressure
Secondary hypertension — has a known cause. The most common causes of secondary high blood pressure are kidney disease, endocrine disorders, heart disease, and medications. It is more common in kids who:
- Are younger than 10 years old
- Blood pressure had previously been normal then there is a sudden increase.
- Have severe hypertension
What problems can high blood pressure cause ? Effect of High Blood Pressure NHLBI
Severe high blood pressure can cause seizures and heart failure if untreated. High blood pressure is also a major risk factor for high blood pressure as an adult. High blood pressure in adults can contribute to early heart attack or stroke.
Can high blood pressure be treated without medication?
For primary hypertension (see Does all high blood pressure have the same cause? above) there are many things you can do to lower blood pressure. Changing your child’s diet, ensuring regular aerobic exercise, and weight loss (if your child is overweight) can have a large effect on reducing blood pressure without medication!
Reducing the amount of salty foods in your child’s diet is one way to lower their blood pressure. Eating more fresh fruits, vegetables, and low-fat dairy products can also help. Everyone in the family should try to eat healthier foods to encourage your child to continue a healthy diet.
Twenty to thirty minutes of aerobic exercise several times each week can help reduce high blood pressure. Aerobic exercise includes walking, swimming, soccer, basketball, biking, or other activities with a lot of movement. Weight lifting and strength training do not help reduce blood pressure. Watching television and playing video/computer games should be limited to less than two hours a day.
Depending on the severity of your child’s high blood pressure your doctor may decide to start a medication.
When is it right to start blood pressure medication?
Medication choice depends on severity, underlying cause of high blood pressure, and if there are risk factors for heart disease. One or more medications may be started if:
- Blood pressure is causing headache or seizures
- Your pediatrician says your child has stage 2 hypertension.
- Stage 1 hypertension that remains after four to six months of changed diet and exercise.
- High blood pressure is causing changes to the walls of the heart.
- Your child has diabetes or high cholesterol.
- If your child has other risks for heart disease or stroke.
What are the kinds of medications for high blood pressure?
There are several different types of medications used to treat high blood pressure in children. These include thiazide diuretics, angiotensin converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), calcium channel blockers, and beta-blockers. Short descriptions of each are provided below. For more information, ask your pediatrician any questions or concerns you might have.
Thiazide diuretics- lower fluid volume throughout the body. Thiazide diuretics are safe, effective, and work best effective when used in combination with a low salt diet. The most commonly used thiazide is hydrochlorothiazide. Side effects are uncommon with low doses of thiazide diuretics.
ACE inhibitors/ARBs- both widen blood vessels to lower blood pressure. The most common side effect of ACE inhibitors is a dry cough. Side effects of ARBs are headaches, dizzyness, drowsiness, or abdominal pain. The most commonly used ACE inhibitors in children are enalapril and lisinopril. Losartan is the most common ARB. These drugs should not be used in sexually active girls due to the potential risk of harm to the baby if the girl becomes pregnant.
Beta blockers - decrease the speed and strength of the heart to lower blood pressure. Side effects can include fatigue, dizziness, difficulty sleeping, decreased ability to exercise, rash, and cold hands. Beta blockers should not be used in children with asthma or heart block. Commonly used beta blockers include metoprolol, atenolol, and bisoprolol.
Calcium channel blockers - cause muscle cells to relax and blood vessels to dilate to reduce blood pressure. Side effects of calcium channel blockers can include headache, dizziness, nausea, or swelling of the lower legs or feet.
Hopefully answering these questions has been helpful for you. If you have additional questions you can check out the other websites below or ask your pediatrician. |
