Normal blood pressure for 9 month old: High blood pressure – infants Information | Mount Sinai
High blood pressure – infants Information | Mount Sinai
Hypertension – infants
High blood pressure (hypertension) is an increase in the force of blood against the arteries in the body. This article focuses on high blood pressure in infants.
An umbilical catheter is a long, soft plastic tube (usually made of silicone) that is placed in the umbilical cord either through the umbilical artery or umbilical vein to allow IV fluids and medications to be given over an extended period of time.
Coarctation of the aorta is a birth defect in which the aorta, the major artery from the heart, is narrowed. The narrowing results in high blood pressure before the point of coarctation and low blood pressure beyond the point of coarctation. Most commonly, coarctation is located so that there is high blood pressure in the upper body and arms and low blood pressure in the lower body and legs. Symptoms can include localized hypertension, cold feet or legs, decreased exercise performance, and heart failure.
Causes
Blood pressure measures how hard the heart is working, and how healthy the arteries are. There are two numbers in each blood pressure measurement:
- The first (top) number is the systolic blood pressure, which measures the force of blood released when the heart beats.
- The second (bottom) number is the diastolic pressure, which measures the pressure in the arteries when the heart is at rest.
Blood pressure measurements are written this way: 120/80. One or both of these numbers can be too high.
Several factors affect blood pressure, including:
- Hormones
- The health of the heart and blood vessels
- The health of the kidneys
High blood pressure in infants may be due to kidney or heart disease that is present at birth (congenital). Common examples include:
- Coarctation of the aorta (narrowing of the large blood vessel of the heart called the aorta)
- Patent ductus arteriosus (blood vessel between the aorta and pulmonary artery that should close after birth, but remains open)
- Bronchopulmonary dysplasia (lung condition that affects newborn babies who were either put on a breathing machine after birth or were born very early)
- Kidney disease involving the kidney tissue
- Renal artery stenosis (narrowing of the major blood vessel of the kidney)
In newborn babies, high blood pressure is often caused by a blood clot in a kidney blood vessel, a complication of having an umbilical artery catheter.
Other causes of high blood pressure in infants may include:
- Certain medicines
- Exposure to illegal drugs such as cocaine
- Certain tumors
- Inherited conditions (problems that run in families)
- Thyroid problems
Blood pressure rises as the baby grows. The average blood pressure in a newborn is 64/41. The average blood pressure in a child 1 month through 2 years old is 95/58. It is normal for these numbers to vary.
Symptoms
Most babies with high blood pressure will not have symptoms. Instead, symptoms may be related to the condition causing the high blood pressure. These symptoms may include:
- Bluish skin
- Failure to grow and gain weight
- Frequent urinary tract infections
- Pale skin (pallor)
- Rapid breathing
Symptoms that may appear if the baby has very high blood pressure include:
- Irritability
- Seizures
- Trouble breathing
- Vomiting
Exams and Tests
In most cases, the only sign of high blood pressure is the blood pressure measurement itself.
Signs of very high blood pressure include:
- Heart failure
- Kidney failure
- Rapid pulse
Blood pressure in infants is measured with an automatic device.
If coarctation of the aorta is the cause, there may be decreased pulses or blood pressure in the legs. A click may be heard if a bicuspid aortic valve occurs with the coarctation.
Other tests in infants with high blood pressure will try to find the cause of the problem. Such tests may include:
- Laboratory tests, including blood and urine tests
- X-rays of the chest or abdomen
- Ultrasounds, including an ultrasound of the working heart (echocardiogram) and of the kidneys
- MRI of the blood vessels
- A special type of x-ray that uses a dye to look at blood vessels (angiography)
Treatment
The treatment depends on the cause of high blood pressure in the infant.
Treatment can include:
- Dialysis to treat kidney failure
- Medicines to lower blood pressure or help the heart pump better
- Surgery (including transplantation surgery or repair of the coarctation)
Outlook (Prognosis)
How well the baby does depends on the cause of high blood pressure and other factors such as:
- Other health problems in the baby
- Whether damage (such as kidney damage) has occurred as a result of the high blood pressure
Possible Complications
Untreated, high blood pressure may lead to:
- Heart or kidney failure
- Organ damage
- Seizures
When to Contact a Medical Professional
Contact your health care provider if your baby:
- Fails to grow and gain weight
- Has bluish skin
- Has frequent urinary tract infections
- Seems irritable
- Tires easily
Take your baby to the emergency department if your baby:
- Has seizures
- Is not responding
- Is vomiting constantly
Prevention
Some causes of high blood pressure run in families.
Talk to your provider before you get pregnant if either parent has a family history of:
- Congenital heart disease
- High blood pressure
- Kidney disease
Also talk to your provider before becoming pregnant if you take medicine for a health problem. Exposure to certain drugs in the womb may increase your baby’s risk for developing problems that can lead to high blood pressure.
Flynn JT. Neonatal hypertension. In: Gleason CA, Juul SE, eds. Avery’s Diseases of the Newborn. 10th ed. Philadelphia, PA: Elsevier; 2018:chap 93.
Macumber IR, Flynn JT. Systemic hypertension. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 472.
Sinha MD, Reid C.
Systemic hypertension. In: Wernovsky G, Anderson RH, Kumar K, et al, eds. Anderson’s Pediatric Cardiology. 4th ed. Philadelphia, PA: Elsevier; 2020:chap 60.
Last reviewed on: 6/7/2022
Reviewed by: Neil K. Kaneshiro, MD, MHA, Clinical Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
Normal Vital Signs
Normal Vital Signs
Pediatric Vital Sign Normal
Ranges
Age Group
| Respiratory
| Heart Rate | Systolic
| Weight
| Weight
|
|---|---|---|---|---|---|
| Newborn | 30 – 50 | 120 – 160 | 50 – 70 | 2 – 3 | 4. 5 – 7 |
| Infant (1-12 months) | 20 – 30 | 80 – 140 | 70 – 100 | 4 – 10 | 9 – 22 |
| Toddler (1-3 yrs.) | 20 – 30 | 80 – 130 | 80 – 110 | 10 – 14 | 22 – 31 |
| Preschooler (3-5 yrs.) | 20 – 30 | 80 – 120 | 80 – 110 | 14 – 18 | 31 – 40 |
| School Age (6-12 yrs.) | 20 – 30 | 70 – 110 | 80 – 120 | 20 – 42 | 41 – 92 |
Adolescent (13+ yrs. ) | 12 – 20 | 55 – 105 | 110 – 120 | >50 | >110 |
REMEMBER:
- The patient’s normal range should
always be taken into consideration. - Heart rate, BP & respiratory rate are
expected to increase during times of fever or stress. - Respiratory rate on infants should be
counted for a full 60 seconds. - In a clinically decompensating child, the
blood pressure will be the last to change. Just
because your pediatric patient’s BP is normal, don’t
assume that your patient is “stable”. - Bradycardia in children is an ominous
sign, usually a result of hypoxia. Act quickly, as this
child is extremely critical.
Act quickly, as this
What should be the pressure in a child
Contents
- Blood pressure in a child
- Normal blood pressure in a child
- Normal blood pressure by gender
- Formulas for calculating blood pressure in children
- The influence of various factors on indicators of arterial pressure
- How to measure a child’s blood pressure
- How to measure it
- When to measure blood pressure
- How to measure blood pressure
- Abnormal blood pressure
Blood pressure is the pressure that blood exerts on the walls of blood vessels. Blood pressure is one of the most important parameters characterizing the functioning of the circulatory system.
Blood pressure is characterized by two indicators – upper and lower values.
The upper value is the systolic pressure, which determines the force with which the heart pushes blood into the arteries when it contracts.
The lower value is the diastolic pressure, which measures the pressure inside an artery when the heart is at rest.
That is, systolic pressure occurs during contraction of the heart muscle, and diastolic pressure during relaxation.
The difference between upper and lower blood pressure is called pulse pressure.
Blood pressure is measured in millimeters of mercury (mmHg).
Child blood pressure
Blood pressure in a child is much lower than that of an adult, this is due to the high elasticity of the vessels, the width of their lumen and the large size of the capillary network.
Both blood pressure indicators increase with age.
Reaching 110 – 120 / 60 – 70 mmHg with age. Art., blood pressure is maintained at this level for a long period of life.
Normal blood pressure in a child
| Age | Blood pressure (mmHg) | |||
|---|---|---|---|---|
| Systolic | Diastolic | |||
| Min | Max | Min | Max | |
| Up to 2 weeks | 60 | 96 | 40 | 50 |
| 2-4 weeks | ||||
| 2 – 12 months | 90 | 112 | 50 | 74 |
| 2 – 3 years | 100 | 112 | 60 | 74 |
| 3-5 years | ||||
| 6 – 9 years | 100 | 122 | 60 | 78 |
| 10 – 12 years | 126 | 70 | 82 | |
| 13 – 15 years | 110 | 136 | 70 | 86 |
Normal blood pressure by gender
| Age, years | Systolic pressure | Diastolic pressure | ||
|---|---|---|---|---|
| Boys | Girls | Boys | Girls | |
| 3 | 85. 96± 6.34 | 84.03± 7.17 | 46.45± 4.86 | 46, 47± 5.32 |
| 4 | 87.85± 7.57 | 87.14± 6.61 | 51.07± 5.21 | 48.91± 6.23 |
| 5 | 92.79± 7.59 | 92.45± 8.96 | 51.52± 7.20 | 51.37± 7.29 |
| 6 | 97.47± 6.15 | 95.81± 7.22 | 54.52± 6.24 | 53.37± 6.02 |
| 7 | 98.04± 8.20 | 95.90± 8.70 | 57.13± 8.20 | 56.40± 9.10 |
| 8 | 97.50± 9.60 | 95.80± 8.60 | 54.90± 10.10 | 56.50± 9.40 |
| 9 | 98, 80± 8.90 | 97.20± 10.40 | 58.20± 7.62 | 58.10± 8.84 |
| 10 | 99.50± 10.80 | 104, 30± 10.40 | 60.70± 8.80 | 62.30± 9.20 |
| 11 | 105.30± 8.09 | 105.90± 10.15 | 62, 90± 7.85 | 61. 70± 8.89 |
| 12 | 103.80± 9.35 | 106.40± 8.95 95 | 67.60 ± 7.20 | |
| 13 | 107.60± 11.07 | 110.20± 8.80 | 64.60± 7.56 | 66.20± 7.05 |
| 14 | 110, 40± 11.10 | 109.05± 10.80 | 60.80± 9.12 | 66.80± 8.88 |
in children
There are special formulas for calculating normal blood pressure in children of different ages.
Age: less than 1 year
Upper value: 76 + 2n (where n is the number of months).
Lower value: 2/3 to 1/2 of the maximum systolic pressure.
Age: older than
Upper value: 90 + 2n (where n is the number of years).
Lower value: 60 + n (where n is the number of years).
Influence of various factors on blood pressure indicators
The blood pressure level of a healthy child can fluctuate quite widely. Blood pressure is also not the same during the day and may depend on various factors, such as:
- psycho-emotional state;
- meteorological conditions;
- physical activity;
- atmospheric pressure;
- sleep;
- lament.
How to measure the pressure of a child
As a rule, the procedure for measuring the pressure of a child is carried out for preventive purposes or in case of detection of violations of the body.
What to measure
The electronic blood pressure monitor is the optimal device for measuring blood pressure. To measure the pressure with a tonometer in a child, it is recommended to purchase special children’s cuffs.
Recommended infant cuff size:
- for newborns – 3 cm;
- for one year olds – 5 cm;
- preschool children – 8 cm;
- adolescents from 12-14 years old – 10 or 11 cm.
The lower edge of the child’s cuff should be no more than 3 cm from the antecubital fossa.
When to measure blood pressure
It is best to carry out the procedure in the morning after the child has woken up or at rest after half an hour of rest.
How to measure pressure
The procedure for measuring pressure in a child under 1 year old is carried out in the supine position.
It is recommended to measure the child’s pressure at least 2 times with an interval of 2-3 minutes. A lower repeated measurement result will reflect the true readings.
Abnormal blood pressure
Significant deviations from the normal age-related blood pressure in a child may indicate a malfunction in the body and require a doctor’s consultation.
Normal blood pressure and heart rate in children
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- Normal blood pressure and heart rate in children
Hello! Tell me, please, what numbers of blood pressure and heart rate are considered normal in a child of 6.5 years? (Ekaterina)
ANSWER: Dear Ekaterina, the rate of blood pressure in children and heart rate in the attached tables.
Age | Blood pressure (mmHg) | |||
Systolic | Diastolic | |||
min | max | min | max | |
up to 2 weeks | 60 | 96 | 40 | 50 |
2-4 weeks | 80 | 112 | 40 | 74 |
2-12 months | 90 | 112 | 50 | 74 |
2-3 years | 100 | 112 | 60 | 74 |
3-5 years | 100 | 116 | 60 | 76 |
6-9 years old | 100 | 122 | 60 | 78 |
10-12 years old | 110 | 126 | 70 | 82 |
13-15 years old | 110 | 136 | 70 | 86 |
Heart rate HR (pulse) in children.
