Nearly half of all Americans have high blood pressure, a major cause of stroke. But it’s not just adults whose numbers are too high.
The AAP guidelines define high blood pressure as 130/80 or higher for children and teens. It considers hypertension for kids 12 and under to be a blood pressure reading at or above the 95th percentile, meaning 95% of other kids who are that same age, gender and height have a lower blood pressure. The guidelines define a normal reading as below the 90th percentile for younger kids and below 120/80 for teens.
In children, it is most common among kids who are obese, but can also be caused by kidney disease, heart abnormalities or other factors and is a serious health risk. High blood pressure at a young age puts kids at risk for heart disease and stroke later in life, and children who have persistent hypertension may develop thicker arteries as early as age 30.
"It's hard on the kidneys and heart,” said Dr. Sarah de Ferranti, director of preventive cardiology at Boston Children's Hospital. “The heart muscle gets thick. Over long periods of time, you could have damage to kidneys."
Dr. Geetha Raghuveer, pediatric cardiologist at Children's Mercy Hospital in Kansas City, Missouri, said high blood pressure among kids is "underrecognized.”
“It's not often flagged in the pediatrician office because it is not always checked," she said.
Blood pressure should be measured yearly starting at age 3, but it can be tough to get accurate measurements. If the proper-sized cuff isn’t available, the measurement will be off, and some kids may resist because they don’t like having their arm squeezed tightly, Raghuveer said.
But keeping track of blood pressure is important to diagnosing other “silent” health issues that may not present symptoms, such as other heart and kidney problems, Raghuveer said. "Those can be quite asymptomatic."
Often, if a child's blood pressure is high, a health care professional may recommend additional tests, such as those that examine urine and blood and ultrasounds to look at the heart or kidneys. Sleep disorders and a history of premature birth also are associated with high blood pressure in youth.
“Most kids with high blood pressure don't have symptoms, but some may experience headaches and blurry vision, and very rarely may have chest pains,” de Ferranti said.
Only about 1% of kids with hypertension are prescribed blood pressure-lowering medications. The AAP guidelines recommend doctors prescribe blood pressure medications if lifestyle changes don’t work, or if the child has another underlying condition.
“Lifestyle changes can make a big impact in helping children avoid having their hypertension diagnosis become a lifelong condition,” she said. Children above a healthy weight can start by eating a nutritious diet and being more active. Aerobic exercise can lower blood pressure because of its effect on blood vessels and the heart, even if weight is not an issue.
Developing lifelong healthy habits in childhood may help avoid health risks in the future.
Offer fruits and vegetables as snacks and avoid sodium – a major culprit when it comes to hypertension, de Ferranti said. Nearly 9 in 10 U.S. children eat too much sodium, according to the CDC. She said packaged, processed and fast foods, which are high in sodium, should be avoided as much as possible.
"Lowering dietary sodium intake and decreasing foods like breads and fast food can make a huge difference," de Ferranti said.