Everything you need to know about paediatric hypertension as a parent

A doctor could advise scheduling a consultation with a kidney specialist (nephrologist) for additional testing if your child has high blood pressure. Picture: Pexels.

A doctor could advise scheduling a consultation with a kidney specialist (nephrologist) for additional testing if your child has high blood pressure. Picture: Pexels.

Published Feb 1, 2023


Blood pressure that is at or above the 95th percentile for children of the same sex, age, and height as your child is considered to be high blood pressure (hypertension) in children.

Because what is deemed normal fluctuates as children grow, there isn’t a straightforward target range for high blood pressure in all children.

High blood pressure is increasingly prevalent in adolescents and teenagers, even though it mostly affects adults. A person’s health conditions or drugs, as well as other characteristics including age, weight, family history and more, can all be contributing factors.

It’s crucial to have your child’s blood pressure measured at least once a year as part of their yearly check-up because hypertension doesn’t frequently create obvious symptoms.

According to estimates from other experts, between 4.7 and 19.4% of children have excessive blood pressure. This figure is based on a child’s gender, race, BMI, genetic propensity and other elements. According to research, for instance, 20% of children who are obese may also have hypertension, according to a study by the National Center for Biotechnology and Information titled “Clinical evaluation of hypertension in children”.

As the clinical definition of hypertension has changed through the years, statistics about paediatric hypertension may fluctuate over time. However, researchers Dr Nisarg Patel and Dr Nicole Walker concur that paediatric hypertension rates and childhood obesity rates are closely related.

What qualifies as paediatric hypertension?

Depending on the child’s age, height, and gender, hypertension in children has different clinical definitions. If your child's blood pressure level is higher than or equal to the 95th percentile for children of the same age, height and sex, they will be diagnosed with hypertension. Additionally, the reader needs to achieve that standard during three different appointment visits.

Teenagers who are 13 and older have the same diagnostic standards as adults. To be classified in this category, blood pressure values must be 130/80 mm Hg or greater.

The systolic pressure, or the pressure inside artery walls while the heart is pounding, is shown by the first (or top) number. The diastolic pressure, or the pressure inside artery walls between heartbeats, is the second (or bottom) number.

What causes paediatric hypertension?

Children with hypertension can have one of two forms.

Although primary hypertension is increasingly prevalent in children, teenagers and adults are still more likely to be affected. It frequently results from lifestyle choices or genetics. Children who are older and heavier are more likely to develop primary hypertension, according to research titled “Characteristics of Paediatric Inpatients with Primary and Secondary Hypertension”.

Children who are overweight or obese, have a family history of hypertension or heart disease, have birth parents who smoked while pregnant, or who are genetically male are all at risk for primary hypertension.

Black children and teenagers (particularly boys) are at a higher risk of hypertension, much like black adults, according to research titled “Racial Differences in Pediatric Hypertension in Relation to Birth Weight and Body Size”.

The reason for the hypertension in your child will need to be determined by more testing. This might involve seeing a cardiologist and getting an echocardiography or electrocardiogram (EKG). Additionally, they might need tests like urinalysis or blood work to monitor the function of their kidneys.

According to research titled “Essential hypertension in children, an increasing worldwide concern”, secondary hypertension affects children more frequently than it does adults. In certain circumstances, your child’s blood pressure may be raised by underlying medical issues or specific drugs.

Heart problems including coarctation (narrowing) of the aorta, Cushing syndrome, hyperthyroidism, adrenal disorders, obstructive sleep apnoea, chronic kidney disease, and polycystic kidney disease are a few of the ailments that are associated with it.

Over-the-counter drugs or supplements like caffeine, diet pills, or ephedra, prescription drugs like oral contraceptives, steroids or central nervous system stimulants, stimulant medications for attention deficit hyperactivity disorder (ADHD), and illegal drugs like amphetamines, cocaine or anabolic steroids are among the substances that can raise blood pressure.

What potential side-effects might children with high blood pressure have?

As your child develops, untreated high blood pressure can cause a number of health issues. According to the National Institute For Communicable Diseases Of South Africa, cardiovascular diseases that start in infancy may have a higher propensity to last into adulthood.

What symptoms of childhood hypertension are there?

There are not always visible indications or symptoms of high blood pressure. Specialists say signs of hypertension are uncommon. Because of this, some publications refer to high blood pressure as the “silent killer”.

That said, your child may have any of the following symptoms when their blood pressure is extremely high (hypertensive crisis): chest tightness or discomfort, nausea or vomiting, seizures, headaches, vision disturbances, or heart palpitations

How can the high blood pressure of my child be treated or controlled?

Adults may experience complications such as renal disease, peripheral arterial disease, heart disease, heart attack or heart failure.

The aim of hypertension therapy is to lower a child’s blood pressure to below the 90th percentile for his or her age, height, and gender. According to Dr Margaret Riley, the target blood pressure for teenagers is under 130/80 mm Hg.

“Your child's paediatrician may first advise lifestyle adjustments over a period of three to six months to manage primary hypertension," she said.

They could advise calorie restriction, frequent exercise, a nutritious diet, and a reduction in salt consumption.

If lifestyle modifications alone are unsuccessful in lowering your child’s blood pressure, your paediatrician may also recommend antihypertensive medication.

According to experts, there is no agreement on the precise medication to use as a starting point for treating high blood pressure in youngsters. Instead, clinicians make their decisions case by case. The paediatrician will often put your child on the lowest dose feasible and then gradually raise it every 2 to 4 weeks as needed.

Secondary hypertension therapy may require further diagnostic testing and specialised care.

How can I keep my child's blood pressure from rising?

Hypertension is not always preventable. Some incidents are brought on by undiagnosed medical conditions or drug use. To identify problems earlier rather than later, check your child’s blood pressure if they have risk factors for illnesses that lead to hypertension.

The following lifestyle changes may be beneficial in situations when high blood pressure is brought on by weight, dietary factors or inactivity:

  • Maintain a healthy diet. The NICD advises eating a diet low in sugar and saturated fats and high in fresh fruits and vegetables. Reducing sodium consumption may also be beneficial, but see a doctor about your child’s salt needs depending on his or her age and weight.
  • Take part in exercise. Children may stay active every day by participating in activities like walking, jogging, bicycling and playing sports. Age determines how much exercise you should get. The typical recommendation for children between the ages of 6 and 17 is to spend at least one hour being active each day.
  • Retain a healthy weight. If you are concerned about your child’s weight, go to their doctor. Your child’s weight may be achieved within the range that is ideal for their age, height, and gender with the support of a plan that your doctor can help you develop.

Children all across the world are becoming more affected by hypertension. Since high blood pressure may go unnoticed, it’s crucial to test for it every year during your child’s medical check-up appointment. If your kid has extra risk factors, you might want to take their blood pressure more frequently.

You may help your child prevent additional health problems linked to high blood pressure as they develop by seeking timely treatment and making lifestyle changes.