High Blood Pressure

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.