Treatment For High Blood Pressure
Specific treatment for high blood pressure will be determined by your child’s doctor based on:
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Your child’s age, overall health, and medical history
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Extent of the condition
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Your child’s tolerance to specific medications, procedures, or treatments
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Expectations for the course of the condition
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Your opinion or preference
If a secondary cause has been found, such as kidney disease, the underlying disease will be treated. If no cause has been determined, the first treatment approach is lifestyle therapy, including the following:
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Weight reduction
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Increasing physical activity
These interventions can lower systolic and diastolic blood pressure, improve the strength of the heart, and lower blood cholesterol. These are all important steps in preventing heart disease as an adult.
Medications to control high blood pressure are only needed in about 1 percent of children with the disorder. Consult your child’s doctor for more information.
When Should You Take A Teen To See A Doctor For High Blood Pressure
You should take your teen to the doctor to measure their blood pressure if:
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High blood pressure runs in the family They should see the doctor to assess if they are genetically predisposed to high blood pressure and whether any early prevention treatment is needed.
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They are overweight This increases their chances of developing high blood pressure, and you should contact your healthcare provider to learn proper ways to shed some pounds and improve their lifestyle to reduce the risk of high blood pressure.
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Their blood pressure is higher than 180/120mmHg They should take a five-minute rest before their blood pressure is rechecked. If it remains above 180/120mmHg, seek medical attention immediately.
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Prescribed medications don’t seem to lower their blood pressure They should see the doctor and go over other treatment plans.
High Blood Pressure In Teenagers: Causes Symptoms And Treatment Explained
High blood pressure is a common health risk often associated with older people. However, the number of teenagers affected by high blood pressure has considerably risen in recent years.
Common causes of hypertension in teenagers may include:
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Certain medications
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How Do I Know If My Child Is Hypertensive
Your child should have his or her blood pressure measured at least once yearly, ideally at each health care encounter. If your childs blood pressure is at or above the 90th percentile, testing should be repeated three times, ideally by manual auscultation . If the average of these three measurements is at or above the 95th percentile, your child should return to his or her health care provider for repeat measurements to confirm that their blood pressure is high. If the average blood pressure is less than the 95th percentile but greater than or equal to the 90th percentile , then your child is prehypertensive and is at risk for developing hypertension. He or she should return in six months for repeat blood pressure measurements to screen for the development of hypertension.
Any child with an average blood pressure at or above the 95th percentile from multiple readings taken over several visits has hypertension.
What Is High Blood Pressure In Children
Blood pressure is the force of blood as it flows through the body’s vessels. Under normal conditions, the heart pumps blood through the vessels all over the body. The vessels widen and contract as needed to keep blood flowing well. In a person with hypertension, however, the blood pushes too hard against the blood vessels, which can cause damage to blood vessels, the heart, and other organs.
It’s easy for adults to tell if they have high blood pressure simply by having blood pressure checks and comparing the numbers to a simple chart. Children have the same tests however, interpreting the numbers is trickier. Your child’s doctor will use charts based on your child’s sex, height, and blood pressure numbers to determine whether or not your child has high blood pressure.
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How To Treat And Care For Teens Suffering From Low Blood Pressure
The usual treatment for low blood pressure is to treat the cause or the condition causing the symptoms of low blood pressure. For example, if your teens hypotension is due to thyroid disorder, then treating it will resolve the issue of low blood pressure as well.
Doctors prescribe treatment plans to raise and maintain the blood pressure readings at optimum levels. The following steps are included in the treatment plan:
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Increased intake of salt until the blood pressure reading returns to normal.
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Maintain adequate hydration by drinking lots of fluids in the form of water and fruit juices.
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Teenage girls should consume more iron rich foods during their menses to compensate for the blood lost during menstruation.
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A healthy and balanced diet containing fruits, vegetables, lean meat, whole grains and low-fat dairy can help maintain normal blood pressure levels.
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Some medicines may be prescribed to treat severe cases of hypotension. These help raise the volume of blood, thereby, raising the blood pressure to normal levels.
Clinical Practice Guideline For Screening And Management Of High Blood Pressure In Children And Adolescents
POTENTIAL CONFLICT OF INTEREST: The authors have indicated that they have no potential conflicts of interest to disclose.
FINANCIAL DISCLOSURE: The authors have indicated that they have no financial relationships relevant to this article to disclose.
Pediatrics
Joseph T. Flynn, David C. Kaelber, Carissa M. Baker-Smith, Douglas Blowey, Aaron E. Carroll, Stephen R. Daniels, Sarah D. de Ferranti, Janis M. Dionne, Bonita Falkner, Susan K. Flinn, Samuel S. Gidding, Celeste Goodwin, Michael G. Leu, Makia E. Powers, Corinna Rea, Joshua Samuels, Madeline Simasek, Vidhu V. Thaker, Elaine M. Urbina, SUBCOMMITTEE ON SCREENING AND MANAGEMENT OF HIGH BLOOD PRESSURE IN CHILDREN Clinical Practice Guideline for Screening and Management of High Blood Pressure in Children and Adolescents. Pediatrics September 2017 140 : e20171904. 10.1542/peds.2017-1904
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How Is A Child’s Blood Pressure Checked
A child’s blood pressure should be checked once a year at their annual exam starting at the age of 3. Your child should sit comfortably in a chair with their feet supported and their arm level with their heart. Your child’s physician or nurse will use a stethoscope and a hand-inflated arm cuff to check their blood pressure.
If a child has a health condition that increases their risk for high blood pressure, such as obesity or kidney disease, their blood pressure will be checked at every doctor visit. If a child’s blood pressure is high at a well-child visit, their blood pressure will also be checked more frequently.
Your child’s pediatrician will track trends in blood pressure over time, not just the initial screening, to accurately identify a diagnosis of hypertension.
Clinical Evaluation Of A Hypertensive Teen
History
A thorough history is essential in guiding the evaluation and management of a hypertensive adolescent. Detailed information regarding the timing when elevated BP were first noted and the presence of co-morbid conditions is crucial for establishing the diagnosis. For this age group, the clinical history should include questions about the use of anabolic steroids, stimulants and caffeine containing energy drinks which can elevate the BP52. A history of snoring in an obese individual should prompt the evaluation for obstructive sleep apnea. History suggestive of renal disease or an endocrine tumor should be elicited.
Physical Examination
A comprehensive physical examination could suggest the underlying cause of hypertension in children and the presence of target organ damage. Attention to the body mass index is essential to identify overweight and obese patients. Table 2 summarizes the physical findings and laboratory investigations to look for common causes of secondary hypertension in the adolescent.
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What Is High Blood Pressure In Children And Teens
Blood pressure is a measure of how hard the blood pushes against the walls of the arteries as it moves through the body. It’s normal for your child’s blood pressure to go up and down throughout the day. But if it stays up, your child has high blood pressure. Another name for high blood pressure is hypertension.
What is normal and what is high blood pressure depends on your child’s age, sex, and height. The numbers change as your child grows.
Blood pressure is described with two numbers. For example, a child’s reading might be 96/57 or “96 over 57.”
- The first number is the systolic pressure. It shows how hard the blood pushes when the heart is pumping.
- The second number is the diastolic pressure. It shows how hard the blood pushes between heartbeats, when the heart is relaxed and filling with blood.
Is Menopause A Key Risk Factor
Research shows that before middle age, males are more likely to experience high blood pressure than females. Then, around the time of menopause, the reverse becomes true. However, health experts disagree on whether this is due to menopause.
Some argue that, until menopause, hormonal factors and specifically the presence of estrogen helps protect people from high blood pressure. When menopause occurs, individuals lose this protection, effectively making menopause the main risk factor for cardiovascular disease among females.
However, some suggest that other factors may increase the risk around this time, such as increased body mass index, aging, and dietary changes, whether hormonal changes also play a role or not.
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How Is High Blood Pressure Treated In Children And Teens
High blood pressure is treated in different ways. Treatment depends on how high the blood pressure is. When it’s just a little high, doctors often treat it with a healthy lifestyle, like eating healthy foods and being active.
If the blood pressure is higher and if a healthy lifestyle doesn’t help lower it enough, the doctor may recommend medicine.
If another health problem is causing the high blood pressure , treating the other health problem may lower the blood pressure. Your child may also need medicine to lower it.
Potassium Level Affects Blood Pressure
Potassium is a naturally occurring mineral that your body uses as an electrolyte, or substance in solution that will conduct electricity. Its vital for normal functioning, as your body relies on electrical charges for countless processes, from cell signaling to nerve impulses to healthy brain function.
Diarrhea, vomiting, excessive sweating , and some drugs may deplete or disrupt your potassium balance. The most common reason that potassium levels arent within normal limits is due to poor dietary choices.
The average reported intake of potassium from food is about half of the recommended 4,700 milligrams per day.10 Research demonstrates that these low levels of potassium may have a significant impact on blood pressure, especially as it relates to the amount of salt normally found in a Western diet.
Dr. Paul Whelton, professor of epidemiology at Tulane University School of Public Health and Tropical Medicine, conducted an analysis in 1997 of more than 29 trials that demonstrated low levels of potassium resulted in higher systolic blood pressure readings.11 Studies performed since then have found similar results.1213 According to Wheltons research:14
The results support the premise that low potassium intake may play an important part in the genesis of high . Increased potassium intake should be considered as a recommendation for prevention and treatment of hypertension, especially in those who are unable to reduce their intake of sodium.
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How High Blood Pressure Is Diagnosed In Teens
To diagnose hypertension in teenagers, blood pressure has to be measured multiple times over a period of 2-4 weeks. Hypertension is not diagnosed on the basis of a single reading unless it is accompanied by symptoms or is an extremely high reading.
Since the normal blood pressure varies with the age, gender and height in children and adolescents, the diagnosis of hypertension in teens are different with that of adults.
As per the criteria that is currently accepted :
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Prehypertension in children refers to that average SBP and/or DBP is equal or greater than the 90th percentile, but less than the 95th percentile.
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Hypertension refers to average SBP and/or DBP is higher than or equal to the 95th percentile for age, sex and height on 3 or more occasions.
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Adolescents who have BP levels higher than or equal to 120/80 mmHg should be categorized as prehypertensive.
Treatment For Specific Situations
Additional treatment options may be needed in certain situations like resistant hypertension or secondary hypertension.
Resistant hypertension refers to blood pressure that remains high after trying at least three different types of blood pressure medication. Someone whose high blood pressure is controlled by taking four different kinds of medication is considered to have resistant hypertension.
Even such hard-to-treat cases can often be managed successfully in time. Your doctor might prescribe a different medication, dose, drug combination, or more aggressive lifestyle changes.
Getting a referral to a heart or kidney specialist may also be useful in treating resistant hypertension.
Secondary hypertension is high blood pressure thats directly caused by another health condition or drug side effect. Blood pressure often drops substantially or even goes back to normal once doctors diagnose and treat the root cause.
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A Note About Sex And Gender
Sex and gender exist on spectrums. This article will use the terms, male, female, or both to refer to sex assigned at birth. .
If blood pressure is too high for too long, it can cause serious damage to the blood vessels.
This can lead to various complications, some of which can be life threatening. They include:
There are ways of managing high blood pressure, or hypertension. The condition does not often cause symptoms, but regular screening can help a person know if preventive measures are necessary.
The United States Preventive Services Task Force estimates that high blood pressure affects around 45% of adults in the U.S.
In this article, we look at the causes of high blood pressure and how to treat it. We also explain the blood pressure measurements that health authorities consider to be typical or too high.
The heart is a muscle that pumps blood around the body. As it travels, the blood delivers oxygen to the bodys vital organs.
Sometimes, a problem in the body makes it harder for the heart to pump blood. For example, this could occur if an artery becomes too narrow.
Persistent high blood pressure can place strain on the walls of the arteries. This can lead to various health problems, some of which can be life threatening.
Doctors measure blood pressure in millimeters of mercury .
Therefore, if blood pressure is 120/80 mm Hg, the systolic pressure is 120 mm Hg and the diastolic pressure is 80 mm Hg.
| Systolic |
What Is Low Blood Pressure In Teens
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Low blood pressure happens when the blood pressure levels are less than normal. The normal blood pressure for a teenager is around 110/70mmHg. followed by the lower value.)
In children aged ten years or less, blood pressure lower than 90/50mmHg is defined as low blood pressure or hypotension .
Low blood pressure can be categorized into three types, the symptoms of which can range from mild to severe.
- Neurally mediated hypotension : It occurs when the child stands for a long time or encounters an upsetting or scary situation. It causes dizziness. However, children usually outgrow NMH .
- Orthostatic hypotension: It occurs while standing up suddenly from a sitting or lying position. It happens when the body is unable to adjust to the sudden change in the blood flow. However, the blood pressure will be back to normal after a few seconds .
- Severe hypotension: It can develop due to severe infections, allergic reactions, severe blood loss due to an injury, or a shock. Severe hypotension can cause complications by preventing the blood from reaching the brain, thus making it a life-threatening condition. In such cases, immediate medical attention is necessary .
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Other Forms Of Therapy
Bariatric surgery has a role in the treatment of hypertension in the morbidly obese adult and might become an option in the obese pediatric adolescent in the future. A recent study by Visockiene et al demonstrated an improvement in metabolic syndrome including hypertension with up to 30% reduction in weight95.
Renal nerve denervation is a therapeutic option in adults with resistant hypertension, which refers to uncontrolled hypertension despite therapy with 3 or more antihypertensives. Studies in animals and humans have shown that the renal nerves play a role in blood pressure regulation. The efficacy of renal nerve denervation was demonstrated in the Symplicity HTN-2 trial where participants with resistant hypertension were randomized to either a treatment arm managed with renal denervation and baseline antihypertensives or the control arm managed with only baseline antihypertensives. A significant change of â32/-12mmHg in blood pressure in the treatment arm compared to a +1/0mmHg change in the control arm was observed 6 months after intervention. These blood pressure changes persisted at 2 years in a follow up study96–98. While renal nerve denervation has not yet been performed in the pediatric population, it might have a role in the future for the treatment of resistant hypertension in the adolescent hypertensive patient.
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