High Blood Pressure In Children

Can not be defined as easily as in adults but high blood pressure in children should not be missed for very good reason. Read it at this doctor’s page:

Incidence of High Blood Pressure in Children:

Figure on a little more than one percent incidence according to a 1987 study of 15,000 junior high school adolescents. African Americans are somewhat higher.

Although there was a 3.5 % incidence on the first reading, by the third reading it dropped to 1.1 %. As always, one reading does not make a case of high blood pressure, just as true in children as in adults. Two thirds of the initial abnormal readings became normal by the third reading.

Significance of High Blood Pressure in Children:

• Few children have signs, symptoms or adverse events though these are possible when hypertension is severe.

• The main significance is the implication for the future in that these children are very likely to have hypertension in adulthood and indeed may start having tissue changes in adolescence.

• Another important significance is that almost all hypertensive children younger than 15 years had secondary high blood pressure. That is hypertension caused by a disease or condition. Only 25 % of 15 to 18 year olds with high readings had secondary hypertension. That’s still a lot more than the 5 % of adult hypertensives who have secondary type.

• Thus it behooves us to look very persistently in children for secondary causes which are quite potentially curable. The best treatment for anything is to remove the cause.

Definition of High Blood Pressure in Children:

It is defined by Age, Sex, and Height.

Here it is: Three separate readings that are at or above the 95th percentile for that age, sex, and height.

Pre-Hypertension would be the 90th to the 95th percentile.

A few representative readings of high blood pressure in children would be:

A 5 year old boy at the 50th percentile of height would have hypertension at 112/72 mm Hg. Add 4 mm systolic for the 95th percentile and subtract 4 mm for the 5th.

A similar girl would be hypertensive at 110/72. Add and subtract 3 mm systolic for the 95th and 5th percentiles.

A 15 year old boy at the 50th percentile of height should be less than 131/83. Add and subtract 4 mm for the 95th and the 5th.

A similar girl should be less than 127/83. Add 4 mm and subtract 3 mm at the 95th and 5th.

(You can find good charts for height percentile at www.kidsgrowth.com)

Doctor’s Practical Guide:

The American Academy of Pediatrics, the American Heart Association and the American Medical Association all recommend screening for high blood pressure in normal children starting at the age of three.

As noted above, the high chance of it being due to a secondary cause demands a diligent search for said cause. A considerable majority will turn out to be of renal origin.

Key points to take away:

• There is high blood pressure in children.

• The sooner in life it starts the sooner adverse events can occur.

• It usually is secondary and potentially curable.

I have written a comprehensive booklet on "How To Take Blood Pressure" with tips and tricks plus a list of pitfalls to avoid. Also included is where and how to get help if you need it. See the table of contents at How To Take Blood Pressure Booklet

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