High Blood Pressure

Blood pressure is the measure of blood pushing against blood vessel walls as the heart pumps blood throughout the body. When a person has high blood pressure—also called hypertension—the blood pumps faster than normal, putting increased pressure and force on the blood vessels as it moves through the body. If left unchecked, high blood pressure can lead to serious health complications in adulthood, such as heart attack, stroke, kidney disease and blindness.

There are three types of high blood pressure:

Primary high blood pressure. Many children and adolescents with high blood pressure are diagnosed with primary high blood pressure. This type of high blood pressure is diagnosed when the exact cause cannot be determined. In many cases, this type of high blood pressure is related to lifestyle factors, such as obesity, lack of regular exercise and unhealthy diet choices.
Secondary high blood pressure. Secondary high blood pressure is high blood pressure that is determined to be caused by a specific underlying medical condition. Conditions that can lead to secondary high blood pressure in children and teenagers include kidney disease and certain types of heart and blood vessel diseases. Secondary high blood pressure can also be caused by certain prescription and over-the-counter medicines and illegal drugs.
White coat hypertension (WCH). This is a condition diagnosed when the blood pressure is high when measured in a doctor’s office, but it is normal at home or in other relaxed settings. This kind of high blood pressure is not thought to be harmful, but a child with WCH may be at increased risk to develop true hypertension later in adolescence or adulthood.

Factors that increase a child's risk for developing high blood pressure include:

Obesity. Excess weight can lead to an increase in blood pressure.
Ethnicity. Some ethnic groups are at an increased risk for primary high blood pressure, especially African-Americans.
Family history. If a child has a family history of high blood pressure, his or her risk for high blood pressure increases.
Prematurity. Children who were born early, or who had very low birth weights, are at increased risk for high blood pressure later in life.

High blood pressure generally has no symptoms. For this reason, it is important to have your child's blood pressure checked at least once a year by his or her primary care physician during regular checkups or well-child visits. This is especially true if any of the above risk factors apply to your child. An early diagnosis will result in better treatment outcomes.

Diagnosis of High Blood Pressure

High blood pressure is diagnosed through a simple measurement that involves placing an inflatable cuff on your child's arm. The measurement may be taken by a doctor or nurse and only takes a minute. To determine whether your child has white coat hypertension, blood pressure checks done at home or at school might also be used.

Blood pressure is measured with two numbers: the systolic pressure and the diastolic pressure. The systolic pressure (sometimes called the "top number" in a blood pressure reading) is the pressure as the heart squeezes to push blood through the vessels. The diastolic pressure (sometimes called the "bottom number") is the pressure as the heart relaxes between heartbeats. A healthy blood pressure in children is determined by gender, age and height. The doctor will determine if your child's blood pressure is healthy based on these factors.

Treatments

Treatment for high blood pressure in children includes:

Diet. Eating a healthy diet can both lower and prevent high blood pressure. Your child's doctor will recommend ways to improve blood pressure through proper nutrition. The Dietary Approaches to Stop Hypertension (DASH) eating plan is a diet your child's doctor may recommend. The DASH eating plan:

Is low in fat and cholesterol
Includes fat-free or low-fat milk and dairy products
Includes fish, poultry and nuts as primary protein sources
Suggests less red meat, sweets, added sugars and sugary drinks
Is rich in nutrients, protein and fiber
Can lower blood pressure by 10-15 points if followed carefully

Exercise. Being active by participating in sports, outdoor play and other physical activities can help improve all areas of your child’s overall wellness, including helping to maintain a healthy blood pressure.
Weight management. Helping your child make the right eating choices to maintain a healthy weight can help lower and prevent high blood pressure. Your child’s doctor can tell you what weight range is healthy for your child's gender, age and height.
Medicine. If a healthy diet and regular physical activity do not lower your child's blood pressure enough, the doctor may prescribe a blood pressure medicine. Medicines that help lower blood pressure include angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), diuretics (sometimes called “water pills”), beta blockers and calcium channel blockers.
Tobacco education. Although cigarette smoke does not cause high blood pressure, it is true that smoking a cigarette temporarily increases the blood pressure. Tobacco use and second-hand smoke exposure also causes many other health problems, including speeding up damage to blood vessel walls. Educate your child about the negative consequences of tobacco use and protect them from secondhand smoke.

If your child has an underlying condition that is causing high blood pressure (secondary high blood pressure), treatment of the underlying condition can also help lower the blood pressure.

Key Points to Remember

High blood pressure puts pressure and strain on blood vessels throughout the body.
Primary high blood pressure has no apparent cause. Secondary high blood pressure is caused by an underlying condition, such as kidney or heart disease.
If left unchecked, high blood pressure can lead to serious health complications in adulthood, such as heart attack, stroke, kidney disease and blindness.
Children who were born prematurely or who are obese, African-American or have a family history of high blood pressure are at an increased risk of developing the condition.
Treatment for high blood pressure in children includes diet, exercise and weight management.

Support Services & Resources

Visit the trusted websites below to learn more about high blood pressure in children.

Riley at IU Health offers a broad range of supportive services to make life better for families who choose us for their children's care.

Learn More About Riley Support Services

American Academy of Pediatrics

The American Academy of Pediatrics provides information about high blood pressure in children on its website, healthychildren.org.

National Kidney Foundation

Visit this website to learn more about high blood pressure and kidney disease in children.

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