Causes Of Hypertension In Children
1. Primary hypertension
Primary hypertension means that the hypertension does not seem to be caused by some other underlyng medical condition. Many doctors think that the incidence of childhood or adolescent hypertension has been rising along with the obesity epidemic. The majority of teens and children over age 6 with hypertension have a family history of hypertension and/or are overweight.
2. Secondary hypertension
Secondary hypertension is caused by a known underlying medical condition. Of these, about
- 80 percent of children have some kind of kidney disease or blood vessel abnormalities
- 5 percent have an endocrinological disorder
- 2 to 5 percent have heart disease
Hypertension in infants with hypertension almost always has a secondary cause. In addition, premature infants have a higher incidence of hypertension.
Among kids with hypertension, especially those who are very young, secondary hypertension is more common than primary hypertension. But among children who are older than 6 to 8 years old, the ratio of primary to secondary hypertension is approaching 50/50.
Can Children Have High Blood Pressure
While a majority of the conversation about high blood pressure; centers on adults, children of all ages, from birth to teens, can have high blood pressure. Just like high blood pressure in adults, there are often no symptoms and early diagnosis;and treatment;are key.
The American Heart Association recommends that all children have yearly blood pressure measurements in order to allow for early detection and intervention.
Why Monitor Blood Pressure
Hypertension is an important health issue in children, because of its association with obesity. High blood pressure is considered a risk factor for heart disease and stroke, and high BP in childhood has been linked to high BP in adulthood.
This calculator can help to determine whether a child has a healthy blood pressure for his/her height, age and gender. In boys and girls, the normal range of blood pressure varies based on height percentile and age. This calculator automatically adjusts for differences in height, age and gender, calculating a child’s height percentile along with blood pressure percentile. The normal blood pressure range, while steadily increasing with age, will shift based on the child’s height.
If you mouse-over the graphs, you’ll see the data values for points you hover over. The pop-up will identify the percentile line, followed by the age , then the value being graphed . Mouse-over the subject’s data point to see the subject’s data values.
The BP reference data include the 50th, 90th, 95th, and 99th percentiles for age and height for both boys and girls. So the graphs on this page show the upper half of the blood pressure range found in children. Normal BP is defined as systolic and diastolic blood pressures that are below the 90th percentile. The systolic number represents BP in blood vessels when a heart beats. The diastolic number is the pressure in blood vessels between beats, when the heart is at rest.
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What Is The Normal Blood Pressure For A Pre
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What Is Normal Blood Pressure For Women
Did you know high blood pressure is common among women? Especially for women in their 40s, 50s, and 60s. In fact, women who have gone through menopause are at an even greater risk.
Health Harvard explains, By the time they reach their 60s and 70s, 70% of women have high blood pressure. After age 75, that figure rises to nearly 80%, according to the CDC. This is why prevention is so important! Here are the normal blood pressure readings for women by age:
- Age 18-29
- Age 40-59
- Age 60+
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From Age 12 Upward A Measurement Of 120/80 Or Lower Is Ideal
Your doctor can use detailed tables to determine more precisely if your childs blood pressure is normal, borderline or high.
The majority of children and teens we see with elevated blood pressure are overweight. For these patients, treatment consists of lifestyle changes that include a doctor-approved diet and physical activity plan. Increased cardiovascular exercise, and a diet low in salt and rich in fruits, vegetables, grains and low-fat dairy has been shown to lower blood pressure. For pre-pubescent children, were not so much trying to achieve weight loss as to help kids grow into their weight. For about 1-2 percent of our patients who have sustained high blood pressure at multiple doctor visits, we prescribe medication along with lifestyle modifications.
What Is Pediatric Low Blood Pressure
Normal blood pressure is between 90/60 and 130/80.
- The top number, or systolic pressure, is a measurement of the pressure in the arteries when the heart muscle contracts.
- The bottom number, or diastolic pressure, is a measurement of the pressure in the arteries between beats of the heart.
Hypotension, or low blood pressure, happens when your childs blood pressure falls below the normal range. A drop in blood pressure is not always a cause for concern, and the severity of the situation depends on the cause.
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Signs And Symptoms Of High Blood Pressure
High blood pressure may not have any symptoms and so hypertension has been labeled “the silent killer.” Longstanding high blood pressure can lead to multiple complications including heart attack, kidney disease, or stroke.
Some people experience symptoms with their high blood pressure. These symptoms include:
- The Feeling of pulsations in the neck or head
Interpreting Blood Pressure Readings
For children aged 1 to 13, the 50th percentile range on the blood pressure tables is considered normal, while elevated blood pressure is anything above the 90th percentile. What’s normal can vary considerably, as these charts group blood pressure in 7 different height categories for each age. Thus, comparing blood pressure readings to these tables is essential when interpreting the results.
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Normal Blood Pressure In Boys
Using the blood pressure tables, below is a sampling of normal blood pressure ranges for boys:
- Normal blood pressure in 1-year-old boys ranges from 85 to 88 for systolic pressure, and 40 to 42 for diastolic pressure.
- For 6-year-old boys, normal systolic pressure ranges from 93 to 97, while the 50th percentile for diastolic blood pressure falls in the range of 54 to 57.
- Normal blood pressure in 12-year-old boys ranges from 101 to 108 systolic pressure over 61 to 63 diastolic pressure.
Will My Child Need Other Tests
At follow-up visits, the doctor may do some additional tests to check the kidneys. These may include:
- Glomerular filtration rate, or GFR, which tells the doctor how well the childs kidneys are working. GFR can be calculated from the results of a simple blood test for creatinine, a waste from muscle activity. When the kidneys are not working well, creatinine builds up to high levels in the blood.
- Urine protein level. A higher level of protein in the urine means there is an increased chance that your childs kidney disease may get worse and that heart and blood vessel disease may develop. Treating high blood pressure may help to reduce your childs urine protein level.
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Signs And Symptoms Of Hypertension
Often, kids and teens with pre-hypertension or stage 1 hypertension wont show any symptoms at all. If your child has stage 2 hypertension, she might experience one or more of the following symptoms:
- abdominal pain
- breathing problems
An infant with stage 2 hypertension may seem irritable, not be feeding properly, or vomiting. Sometimes these infants are diagnosed with failure to thrive.
What Are Signs Of High Blood Pressure In Kids
Hypertension is often a silent condition. Typically, there aren’t obvious symptoms to let parents know their child has high blood pressure; it is often diagnosed when the doctor discovers it during an exam. This is why regular blood pressure screening is so important.
Some children with high blood pressure may experience frequent headaches, changes in vision or dizziness. If your child complains of these symptoms, contact your pediatrician.
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How Is Blood Pressure Measured
Blood pressure is measured in millimeters of mercury . A typical normal blood pressure in an adult is 120/80 mm Hg, or “120 over 80.” The top number refers to the pressure when the heart is pushing blood out through the arteries . The bottom number refers to the pressure when the heart is at restbetween beats .
Its easy to tell whether an adult has hypertension, because theres a standard set of measurements:
- Normal blood pressuresystolic < 120 mmHg and diastolic < 80 mm Hg
- Pre-hypertensionsystolic 120-139 mmHg or diastolic 80-89 mmHg
- Stage 1 hypertensionsystolic 140-159 mmHg or diastolic 90-99 mmHg
- Stage 2 hypertensionsystolic 160 or diastolic 100 mmHg
But its harder with children. Thats because there are no universal cut-offs as there are for adults; instead, whether a child has hypertension depends on how his blood pressure compares to his peers .
- Pre-hypertension90th to 95th percentile
- Stage 1 hypertension95th 99th
- Stage 2 hypertensionanything higher than 99th plus 5 mm mercury
Normal Blood Pressure For Men
Men are recommended to have an average normal blood pressure of 120/80; however, as;we have noted, there are varying factors to consider when determining what works for each person. What is normal for a man in his 30s is not deemed a normal reading for a man in his 60s.
The following are the average blood pressures and the corresponding lows and highs for men from ages 15 to 64 years.
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Can Primary Hypertension Be Prevented
Pediatricians are making great efforts to prevent obesity and stem the tide of problems that accompany it. We believe that promoting healthy lifestyle choices will help combat this trend and will go a long way towards preventing primary hypertension in children .
Some things are being donenutritional information is being made more readily available, theres one push to provide healthy options in schools and another to remove soft drinks from thembut still, it often comes down to families making the right decisions. We are dedicated to educating families to assist with appropriate dietary and activity choices to improve overall health and reduce the risk of hypertension.
What Is Blood Pressure
Blood pressure, measured with a blood pressure cuff and stethoscope by a nurse or other health care provider, is the force of the blood pushing against the artery walls.
Two numbers are recorded when measuring blood pressure:
The higher number, or systolic pressure, refers to the highest pressure inside the artery. It occurs;when the heart contracts and pumps blood;into the body.
The lower number, or diastolic pressure, refers to the lowest pressure inside the artery. It occurs;when the heart relaxes and fills with blood.
Each time the heart beats, it pumps blood into the arteries, resulting in the highest blood pressure, the systolic pressure,;as the heart contracts, and the lowest blood pressure, the diastolic pressure, as the heart relaxes.
Both the systolic and diastolic pressures are recorded as “mm Hg” . This recording represents how high the mercury column is raised by the pressure of the blood.
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Measurement And Detection Of Elevated Blood Pressure
In 2013, the U.S. Preventive Services Task Force and the American Academy of Family Physicians cited insufficient evidence to recommend screening for high blood pressure in average-risk children.20,21 Based primarily on expert opinion, the 2017 AAP guidelines recommend measuring blood pressure annually beginning at three years of age, and the 2016 European Society of Hypertension guidelines recommend screening every two years beginning at three years of age.8,11 Measurements should occur at every health care encounter in children and adolescents with risk factors .8,11 Blood pressure should be measured in children younger than three years only if they have risk factors for hypertension, which includes the same risk factors as older children in addition to prematurity, a family history of congenital renal disease, a history of organ or bone marrow transplant, malignancy, elevated intracranial pressure, and systemic illnesses known to increase blood pressure.8
Determining blood pressure cuff size in children and adolescents. Measure arm circumference midway between the olecranon and acromial process. The inflatable bladder width should be at least 40% of the arm circumference, and the bladder length should be 80% to 100% of the arm circumference.
Reprinted with permission from Luma GB, Spiotta RT. Hypertension in children and adolescents. Am Fam Physician. 2006;73:1560.
Algorithm for managing elevated blood pressure in children and adolescents.
What Is White Coat Hypertension
White coat hypertension is when a childs blood pressure readings are high at the doctors office , but normal outside of the office .
This is pretty common in kids. By some estimations, between 30 and 40 percent of kids who have high blood pressure in the office actually have white-coat hypertension.
White coat hypertension is still a risk. Everyones blood pressure changes from time to timeits lower when youre asleep, for examplebut if a childs blood pressure continually rises when shes anxious , it can be sign of high blood pressure at other times and potentially cause the same kinds of damage that standard hypertension causes.
White coat hypertension is diagnosed by taking the childs blood pressure outside of the doctors office. This can be done in different ways:
- Some parents feel comfortable doing it at home.
- Sometimes we make arrangements for a school nurse to check the childs blood pressure.
- Your childs doctor might recommend that she wear an ambulatory blood pressure monitoring devicea blood pressure cuff attached to a small device that sits on her belt , and measures her blood pressure at regular intervals over the course of 24 hours. This device is about the size of a deck of cards and is usually tolerated very well.
If your child is diagnosed with white coat hypertension, her doctor may still want to follow her, since some children with white coat hypertension will develop actual hypertension in the future.
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Normal Blood Pressure Range For Children By Age And Gender
The normal bp range changes continuously for children throughout childhood, and the blood pressure is lowest in infancy and steadily increases till the child turns 10. Also, it is important to note that the normal BP is different for girls and boys belonging to the same age group.
As mentioned earlier, it is least likely for children to suffer from blood pressure problems unless they have an underlying condition such as a kidney disease or diabetes, and therefore, doctors rarely check the BP in children during their regular checkups.
Determining the normal blood pressure range in children is a little complicated, and it all depends on the size and age of the child. One rule of thumb that doctors use to determine BP troubles in children is that, a child is considered to be suffering from Prehypertension. If he/she has a blood pressure higher than that of 90% of the children of the same age and size. The child is said to have hypertension if he/she has a blood pressure higher than that of 95% of the children of the same age and size.
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What Is The Normal Blood Pressure For Children
Monitoring BP is not necessarily for grown-ups only. Children can and may suffer from hypotension or hypertension, as well. Just like adults, there is also a cut off rate to child bp. It varies by age.
Starting from age 3, the American Heart Association recommends that every childs blood pressure be monitored. This is because as early as this age, underlying health problems may cause abnormal bp.
And if you are quick to spot changes in your sons or daughters BP then you might be able to stop problems before they even start.
Average BP for kids 3 to 6 years old:
The normal blood pressure in children ages 3 to 6 years old is 104/63 to 116/74 mm/hg. This will also vary depending on the size and gender of the child. If the child is somewhat tall or big, then you can expect a higher BP rate than that of smaller kids.
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What Is A Normal Blood Pressure For A Child
There isn’t one single number or blood pressure that is considered normal for all children. A healthy blood pressure for a child depends on their age, height and gender.
For children under the age of 13, your pediatrician will use a percentile chart to compare your child’s blood pressure to peers of the same age, height and gender. This allows a more precise indication if a young child is showing high blood pressure. A child is considered to have an elevated blood pressure if their blood pressure falls above the 90th percentile, and hypertension if they are above the 95th percentile.
Over the age of 13, normal blood pressure ranges are the same for teenagers as they are for adults:
- Normal blood pressure: Less than 120/80 mm Hg
- Elevated blood pressure: Systolic between 120-129 mm Hg and diastolic less than 80 mm Hg
- Hypertension: Top or bottom number higher than 130/80 mm Hg
If your child’s pediatrician notices a trend of high blood pressure readings, they will closely monitor your child’s blood pressure or refer you to a specialist to address any health concerns. They may have your child wear a 24-hour, portable blood pressure monitoring device . This can be worn at home during your child’s normal routine and takes measurements every 20 to 30 minutes during the daytime and 30 to 60 minutes at night.