Many people think of high blood pressure (hypertension) as a problem you need to start worrying about as you get older. Unfortunately, it’s a health risk that affects plenty of young people, too.
“Pediatric high blood pressure is becoming more common in children and teens,” says Rebecca Lombel, M.D., a pediatric nephrologist (kidney specialist) at Henry Ford Health. “That’s concerning, since kids who have hypertension often become adults who have hypertension—and high blood pressure is a major cause of heart disease.”
Here’s what parents and families should know about blood pressure in kids.
What Is Pediatric Hypertension?
Hypertension happens when the pressure in blood vessels is too high. Over time, that increases the risk of serious problems like heart attack and stroke.
There are two categories of high blood pressure:
- Secondary hypertension develops as a result of another problem, like kidney disease or thyroid problems. “If we see high blood pressure in children, especially young kids, it’s important to do an evaluation to determine whether there’s some other underlying cause,” Dr. Lombel says.
- Primary hypertension is the name given to high blood pressure that occurs without a single, identifiable cause. It can affect anyone, but it’s more common in people with obesity. As obesity rates have increased among U.S. children, so have hypertension rates. “Between 3% to 5% of children have high blood pressure. But among children with obesity, it’s as many as 30%,” Dr. Lombel says.
Most of the time, high blood pressure doesn’t cause any symptoms. Children with high blood pressure usually feel fine. But when it’s extremely high, it can sometimes cause symptoms such as:
- Headaches
- Nosebleeds
- Vision changes
Risks of Pediatric High Blood Pressure
High blood pressure in kids doesn’t usually cause problems right away—but that doesn’t mean you should ignore it. Over time, it damages the blood vessels. That increases a person’s risk of developing problems such as:
- Heart disease
- Heart attack
- Stroke
- Kidney disease
Diagnosing High Blood Pressure in Kids
A single high blood pressure reading doesn’t automatically mean a child has high blood pressure. Factors like stress, exercise or salty meals can cause blood pressure to rise temporarily. A child is diagnosed with hypertension if they have three high readings, measured on three separate days.
Starting at age 3, pediatricians begin measuring blood pressure at every well-child visit. That’s one of many reasons why it’s important not to miss your annual checkup.
“It’s important to see your pediatrician each year so we can look at blood pressure trends over time,” Dr. Lombel says.
What Counts as High?
Blood pressure changes as kids grow, so there’s no single number that spells trouble. The definition of high blood pressure is different in kids and teens:
Under age 13
In kids under 13, doctors diagnose high blood pressure by comparing their blood pressure reading to the blood pressure numbers of other kids their age, height and sex.
- Elevated blood pressure is diagnosed when a child’s blood pressure readings fall in the 90th to 95th percentile (that is, they have a reading higher than 90% to 95% of their peers).
- High blood pressure is diagnosed when a child’s blood pressure reading is above the 95th percentile (higher than 95% of their peers).
Over age 13
In teenagers, doctors use the same scale that measures blood pressure in adults:
- Elevated blood pressure is 120-129/less than 80 millimeters of mercury (mmHg)
- High blood pressure is 130/80 mmHg or higher
High Blood Pressure Treatment: Lifestyle Changes
Doctors treat pediatric hypertension with a combination of lifestyle changes and, sometimes, medicine.
When kids have elevated blood pressure, Dr. Lombel usually recommends starting with lifestyle adjustments to lower blood pressure. Kids (and adults) can improve their numbers by making changes to exercise habits and adopting a more heart-healthy diet.
Those changes include:
- Lowering sodium (salt) intake
- Eating more fresh fruits and vegetables
- Eating less fast food and processed food
- Getting more physical activity
“These are habits that benefit everyone, so I recommend that the whole family make changes to move more together,” Dr. Lombel says. Families can make exercise fun by having dance parties, going for walks together or taking bike rides, she suggests. “Being more active can lower blood pressure even if you don’t lose weight,” she adds.
Diet changes can feel intimidating, but they don’t have to be boring. Your pediatrician or a dietitian can help you make changes to your plate—like finding tasty ways to lower salt, which can have a big effect on blood pressure.
Medication for Pediatric Hypertension
If lifestyle changes aren’t enough—or kids come in with higher blood pressure numbers—medications can help bring the pressure down to safer levels. “We have a variety of medications we can use, and children usually do well on them with few side effects,” Dr. Lombel says.
In other words: There are lots of good reasons to treat pediatric hypertension, and no good reasons to ignore it.
“High blood pressure isn’t a reason to panic. I tell kids it’s not something that will harm them in the next days, weeks, or even months,” Dr. Lombel says. “But we want kids to be healthy for years to come—and luckily, there are things we can do to manage high blood pressure so they can live long, healthy lives.”
Reviewed by Rebecca Lombel, M.D., a pediatric nephrologist at Henry Ford Health who sees patients in Detroit.
