High blood pressure and children: Watch your child's weight

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High blood pressure and children: Watch your child's weight

A Mayo Clinic specialist explains how obesity and high blood pressure threaten children's health.

Unhealthy snacks, sugar-laden sodas and too many hours playing video games are taking their toll on children. Among other problems, these unhealthy habits may be contributing to high blood pressure (hypertension). Once considered only a threat to adults, high blood pressure is now affecting more children — jeopardizing their potential for a healthy future.

Bruce Morgenstern, M.D., chief of the Division of Pediatric Nephrology, Phoenix Children's Hospital, and a physician liaison at Mayo Clinic, Scottsdale, Ariz., is a national expert on diagnosing and treating high blood pressure in children. Here, he explains how high blood pressure is threatening children's health, and what can be done about it.

photo of Bruce Z. Morgenstern, M.D.

What causes high blood pressure in children?

For some children, high blood pressure is caused by problems with the kidneys or heart. But for a growing number of kids, poor lifestyle habits — such as an unhealthy diet and lack of exercise — contribute to high blood pressure. High blood pressure in children has become a natural extension of the nationwide obesity epidemic.

Why worry about high blood pressure in children?

High blood pressure can cause stroke, heart failure and kidney disease in children, just as in adults. And being overweight — with or without high blood pressure — increases the risk of other cardiovascular problems, as well as diabetes.

When should blood pressure checks begin?

For healthy children, blood pressure should be checked during routine medical visits beginning at age 3. Blood pressure should also be checked at least once during a course of treatment for any acute illness. If your child has pneumonia, for example, and has two or three visits to the doctor, his or her blood pressure should be checked at least once.

If your child has a condition known to increase the risk of high blood pressure — including prematurity, low birth weight, congenital heart disease, and certain urinary or kidney problems — blood pressure checks may begin during infancy.

How often should children have their blood pressure checked?

If your child's blood pressure is normal, routine checks during well-child visits are enough. If your child's blood pressure is slightly elevated, it should be checked again within six months. If it's still high, more measurements should be taken on at least two separate occasions — generally within a few weeks — to confirm the diagnosis.

What if no other symptoms are present?

High blood pressure is a relatively silent condition. Often, signs and symptoms — such as headaches, visual changes, dizziness, shortness of breath and fatigue — don't appear unless high blood pressure becomes severe.

Can high blood pressure in children be prevented?

Changing modifiable risk factors may help. These are risk factors you can do something about. For example, a child who gets more exercise and eats a healthier diet is less likely to develop high blood pressure, even if high blood pressure runs in the family.

Smoking and drinking are other modifiable risk factors. Obviously you don't see a lot of that in 7-year-olds, but it's common among adolescents — and secondhand smoke is a risk at any age. Muscle-building steroids and other street drugs also may contribute to high blood pressure.

What if a child doesn't have high blood pressure but is a little overweight and doesn't get much physical activity?

This is still cause for concern. It's also an indication to act now. If blood pressure is elevated when a child is young, the odds are quite high that it'll be elevated in adulthood — putting the child at risk of potentially life-threatening conditions.

Besides healthy eating and regular physical activity, what else can parents watch out for?

Pay attention to breathing problems your child may have while sleeping. Children who have sleep-disordered breathing, such as sleep apnea, often have problems with high blood pressure — particularly children who are overweight. Screening for sleep-related breathing problems takes just a few minutes in the doctor's office.

What happens if a child is diagnosed with high blood pressure?

Treatment depends on what's causing the high blood pressure. Healthy lifestyle changes — such as more physical activity and a healthier diet — can have a dramatic effect on high blood pressure. Some children also need medication to control their blood pressure.

Aren't we just adding more labels to children by identifying high blood pressure as an issue?

Years ago, parents put babies to sleep on their stomachs, and children went without car seats and bike helmets. Although no one was aware of the risks, the risks were still there. Likewise, it's important to increase awareness of the dangers of obesity and high blood pressure in children. Although heart attacks are unlikely in childhood, high blood pressure sets the stage for a lifetime of serious health problems.

Last Updated: 07/14/2006
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