Medical: Detecting high blood pressure in kids

High blood pressure isn’t just an adult problem. The condition can occur even in kids. Researchers estimate up to 14 percent of children in the U.S. have high blood pressure. Rates are slightly higher among males than females. The American Heart Association reports between 1988 and 1999, the rate of prehypertension (above normal) among children and adolescents increased 2.3 percent. During the same time period, the rate of hypertension rose 1 percent.

Many health experts link the rise in childhood hypertension to the obesity epidemic. Roughly 32 percent of children in the U.S. ages 2 to 19 are overweight or obese. A recent study in the journal, Archives of Pediatrics and Adolescent Medicine, found sedentary behavior (especially time spent watching television) to be strongly associated with an increased risk for elevated blood pressure.

Children with high blood pressure are at risk for sleep apnea, a condition characterized by brief periods of breathing cessation during sleep. More importantly, hypertension tends to persist into adulthood. Over time, the heart has to work harder to get blood through the body, increasing risk for heart failure. The excess force on the blood vessels can increase the risk for an aneurysm (ballooning in the wall of a weak section of an artery). In the brain, a ruptured aneurysm can cause a stroke. The excess force also damages the blood vessels and can cause them to narrow, affecting the health of the kidneys, eyes and heart.

Among adults, normal blood pressure is a systolic reading of less than 120 and a diastolic reading of less than 80. High blood pressure, or hypertension, is a systolic pressure of 140 or higher OR a diastolic pressure of 90 or higher.

For children, there is no single measurement for high blood pressure, because blood pressure rises as a child grows. Thus, normal blood pressure for a four-year-old is different from that of a 12-year-old. Instead, doctors must compare a child’s blood pressure reading against a chart that takes into account age, sex, height and weight. Matthew Hansen, M.D., Researcher with Oregon Health & Science University, believes this lack of a single blood pressure target means that some children with high blood pressure are not getting diagnosed and treated.

Hansen and his colleagues recently performed a survey of children seen in a pediatric clinic. The researchers found roughly 75 percent of the children had high blood pressure, but were not diagnosed with the condition by their health care provider.

Once high blood pressure is detected, it should be treated. Cardiologist, Maureen Mays, M.D., recommends doctors first suggest diet, exercise and weight loss to bring the blood pressure under control. She doesn’t like using blood pressure medications for children because none are approved specifically for use in children. In addition, small children have a hard time swallowing pills. Mays also recommends parents avoid excess salt in a child’s diet (especially for children under five), because a child’s kidneys don’t handle salt well.