Hypertension is traditionally considered as disease of old age. But now almost every 5th person is suffering from hypertension. Young adults and even children also are not untouched.
In simple words, Hypertension = high blood pressure; i.e. more than 95th centile of same age, sex and height. There is no cut off figure for all children (like in adults where 120/80 mmhg is considered normal) rather charts for blood pressure for children.
2 types: Primary (Essential) and secondary
In less than 10 years of age, hypertension is usually secondary to some medical condition.
In children incidence is on a rise due to changing lifestyle. It can develop for the same reason as adults too (i.e. junk food, no exercise and overweight).
Genetic as well as environment
- Obesity or overweight child
- High blood sugar level (Diabetes)
- High cholesterol or triglycerides
- Positive family history
Due to underlying medical conditions like
- Heart disease (eg. Coaractation of aorta)
- Kidney disease (eg. Polycystic kidney diease, chronic kidney disease, RTA)
- Adrenal gland disorder (including pheocromocytoma)
- Metabolic disoreders (eg. Hyperthyroidism)
Premature babies and low birth weight babies are also at risk for hypertension.
High blood pressure usually does not cause any symptoms in children.
Parents: To do list (that will help you to get maximum out of your visit to child doctor)
- Note down any symptoms child have (if any)
- Reports of any blood test done in past
- Family history (both from mother and father side)
- List of medications, if any, your child is taking.
- Child’s daily routine in context of diet and physical activities.
- Note down all the queries which you have (no matter how silly the question may sound to you). It is your right to know in detail regarding health status of your child.
Painless procedure of Blood pressure (BP) measurement using inflatable arm cuff will help reach diagnosis. Cuff sizes will vary as per arm size of child so that it covers 2/3rd of circumference of child’s arm.
BP reading has 2 numbers: First (or higher) is systolic pressure and second (or lower) is diastolic pressure.
Diagnosis can only be made after taking minimum 3 readings over a course of 3 visits.
Some tests will be done to know the cause of high BP which will include
- Blood tests like blood sugar, kidney function test, blood count, cholesterol etc.
- Urine test
- Echocardiogram to rule out heart disease
- Ultrasound abdomen (specially kidneys)
- Repeated BP monitoring
Simple lifestyle modification can help like better eating habits and more physical activity. But some children might need medication as well.
Medications include Diuretics, beta blockers, ACE inhibitors etc.
If hypertension is due to obesity, than with lifestyle modification will help and gradually medications can be stopped. But if it is due to some underlying medical condition, treatment of that condition will lead to stoppage of anti hypertensive medications.
Life style modification:
High blood pressure is treated similarly in children and adults, typically starting with lifestyle changes.
- Weight management
- Salt restriction
- Healthy diet
- Physical activity
- Psychological support from family
Feel free to contact your child specialist or Maya clinic for any queries.
Dr Rahul varma
“Healthy kids, happy family”