Stories about: high blood pressure

Hypertension in kids: When to refer

high blood presssure
(Illustration: Fawn Gracey)

We typically associate hypertension with older people, but elevated blood pressure isn’t an uncommon finding in children and adolescents. According to the American Academy of Pediatrics (AAP), pediatric hypertension occurs in 2 to 5 percent of kids and is one of the top five chronic diseases in children.

Despite those numbers, the diagnosis is missed in up to 75 percent of pediatric patients in primary care settings. “We should be checking blood pressure at every routine well-child visit for kids age 3 and older, and more often in kids with cardiometabolic risk factors, such as obesity and diabetes,” says Corinna Rea, MD, MPH, a pediatrician in Boston Children’s Primary Care at Longwood. …Read More

It’s complicated: Identifying and treating high blood pressure in children

high-blood-pressure-chidren-heart-center

High blood pressure is notoriously difficult to detect in children. And the consequences of undiagnosed hypertension can be severe.

Sustained high blood pressure can lead to target end-organ disease, meaning long term effects on:

  • the kidney, e.g. renal insufficiency and ultimately end stage kidney disease
  • the heart, e.g. left ventricular hypertrophy and ultimately congestive heart failure

In children, “the difference between normal and abnormal blood pressure can be small, depending on factors like age, height and weight,” says Sarah de Ferranti, MD, director of the Preventive Cardiology Program at Boston Children’s Hospital.

A reading of 120/75 would be:

  • Stage two hypertension in a two-year old
  • Stage one hypertension in a seven-year old
  • Pre-hypertension in an 11-year old
  • Either normal or pre-hypertension in a 17-year old
  • A normal reading for an adult

“Not all kids with high blood pressure are overweight, but all overweight kids are at risk for high blood pressure,” adds de Ferranti. …Read More