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Normal blood pressure for school age child. Normal Blood Pressure for School-Age Children: Understanding Hypertension in Kids

What is considered a normal blood pressure range for children. How is high blood pressure diagnosed in kids. What are the causes and symptoms of hypertension in children. How can parents help prevent and manage high blood pressure in their kids.

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Understanding Blood Pressure in Children

Blood pressure is a crucial health indicator that’s not exclusive to adults. Contrary to common belief, children can also experience hypertension, or high blood pressure. The American Academy of Pediatrics (AAP) estimates that approximately 3.5% of children and teenagers have high blood pressure. This condition, if left untreated, can lead to severe complications such as heart disease, kidney failure, stroke, and vision loss.

Dr. Alan Sing, a pediatric cardiologist at Pediatric Heart Specialists, explains, “A blood pressure reading measures the force of blood against the walls of arteries. This pressure is what your heart has to pump against to get blood out to the rest of your body. If blood pressure is higher, then the heart has to work harder. Over time, this high blood pressure can cause damage to different organ systems in the body.”

How Is Blood Pressure Measured in Children?

Regular blood pressure screenings are essential for identifying hypertension in children. These screenings typically begin at the age of 3 and are conducted annually during well-child visits. The process involves the following steps:

  • The child sits comfortably in a chair with feet supported
  • The child’s arm is positioned at heart level
  • A healthcare professional uses a stethoscope and a hand-inflated arm cuff to check blood pressure

For children with health conditions that increase their risk of high blood pressure, such as obesity or kidney disease, blood pressure is checked at every doctor’s visit. If a child’s blood pressure is high during a well-child visit, more frequent checks will be scheduled.

Ambulatory Blood Pressure Monitoring

In some cases, a pediatrician may recommend a 24-hour portable blood pressure monitoring device, known as an ambulatory blood pressure monitor (ABPM). This device takes measurements every 20 to 30 minutes during the day and every 30 to 60 minutes at night, providing a comprehensive picture of the child’s blood pressure throughout a typical day.

Normal Blood Pressure Ranges for Children

Determining a normal blood pressure for children is not as straightforward as it is for adults. The healthy range depends on the child’s age, height, and gender. For children under 13, pediatricians use percentile charts to compare a child’s blood pressure to peers of the same age, height, and gender.

Blood Pressure Categories for Children Under 13

  • Elevated blood pressure: Above the 90th percentile
  • Hypertension: Above the 95th percentile

Blood Pressure Categories for Children 13 and Older

For teenagers 13 and older, the normal blood pressure ranges are the same as for adults:

  • Normal blood pressure: Less than 120/80 mm Hg
  • Elevated blood pressure: Systolic (top number) between 120-129 mm Hg and diastolic (bottom number) less than 80 mm Hg
  • Hypertension: Top or bottom number higher than 130/80 mm Hg

Recognizing Signs of High Blood Pressure in Children

Hypertension in children is often referred to as a “silent condition” because it typically doesn’t present obvious symptoms. This is why regular blood pressure screenings are crucial. However, some children with high blood pressure may experience:

  • Frequent headaches
  • Changes in vision
  • Dizziness

If your child complains of these symptoms, it’s important to consult with your pediatrician promptly.

Causes of High Blood Pressure in Children

High blood pressure in children can be attributed to various factors. These causes can be broadly categorized into two types: primary hypertension and secondary hypertension.

Primary Hypertension

Primary hypertension, more common in older children, has no disease-related cause. Factors contributing to primary hypertension include:

  • Obesity or being overweight
  • High-sodium diet
  • Genetic predisposition
  • Stress

Secondary Hypertension

Secondary hypertension, more common in younger children (under 6), is caused by an underlying medical condition. These conditions may include:

  • Kidney disease
  • Congenital or acquired heart disease
  • Thyroid or adrenal disease
  • Diabetes

Preventing and Managing High Blood Pressure in Children

While some causes of high blood pressure in children are beyond control, there are several strategies parents can employ to help prevent and manage this condition:

  1. Encourage a healthy diet low in sodium and rich in fruits, vegetables, and whole grains
  2. Promote regular physical activity
  3. Maintain a healthy weight
  4. Limit screen time and encourage active play
  5. Ensure adequate sleep
  6. Manage stress through relaxation techniques or counseling if necessary
  7. Attend regular check-ups and follow your pediatrician’s recommendations

The Importance of Early Detection and Treatment

Early detection and treatment of high blood pressure in children are crucial for preventing long-term health complications. Regular screenings, a healthy lifestyle, and prompt medical attention when necessary can significantly improve outcomes for children with hypertension.

Is medication necessary for treating high blood pressure in children? While lifestyle changes are often the first line of treatment, in some cases, medication may be prescribed. The decision to use medication depends on the severity of the hypertension, its underlying cause, and the child’s overall health. Your pediatrician or a pediatric cardiologist can provide guidance on the most appropriate treatment plan for your child.

The Role of Diet in Managing Pediatric Hypertension

Diet plays a crucial role in managing blood pressure, even in children. The DASH (Dietary Approaches to Stop Hypertension) diet, which has been successful in adults, can be adapted for children with some modifications. This diet emphasizes:

  • Fruits and vegetables
  • Whole grains
  • Low-fat dairy products
  • Lean proteins
  • Limited added sugars and saturated fats

How can parents encourage children to follow a heart-healthy diet? Making dietary changes can be challenging, especially for children. Here are some strategies to make heart-healthy eating more appealing:

  1. Involve children in meal planning and preparation
  2. Make healthy snacks easily accessible
  3. Be a role model by adopting healthy eating habits yourself
  4. Gradually introduce new foods and flavors
  5. Use creative presentations to make healthy foods more appealing

Physical Activity and Its Impact on Children’s Blood Pressure

Regular physical activity is essential for maintaining healthy blood pressure in children. The American Heart Association recommends that children and adolescents participate in at least 60 minutes of moderate to vigorous physical activity every day.

What types of physical activities are best for children with high blood pressure? While any form of physical activity is beneficial, some activities are particularly effective in promoting cardiovascular health:

  • Aerobic activities: Swimming, cycling, brisk walking, or jogging
  • Team sports: Basketball, soccer, or volleyball
  • Dance or martial arts
  • Active outdoor play

It’s important to choose activities that the child enjoys to encourage long-term adherence. Always consult with your pediatrician before starting a new exercise regimen, especially if your child has been diagnosed with hypertension.

The Connection Between Childhood Obesity and Hypertension

Childhood obesity is a significant risk factor for hypertension in children. As the prevalence of childhood obesity has increased in recent years, so has the incidence of high blood pressure in children.

How does obesity contribute to high blood pressure in children? Excess body weight can lead to hypertension through several mechanisms:

  • Increased blood volume to supply the extra tissue
  • Higher insulin levels, which can cause sodium retention and increased blood volume
  • Activation of the sympathetic nervous system, leading to increased heart rate and blood vessel constriction
  • Hormonal changes that affect blood pressure regulation

Addressing childhood obesity through a combination of dietary changes, increased physical activity, and behavioral modifications can significantly improve blood pressure in overweight or obese children.

The Impact of Sleep on Children’s Blood Pressure

Adequate sleep is crucial for overall health, including maintaining healthy blood pressure. Research has shown that children who don’t get enough sleep are at higher risk of developing hypertension.

How much sleep do children need for optimal health? The American Academy of Sleep Medicine recommends the following sleep durations:

  • Children 3-5 years old: 10-13 hours per 24 hours (including naps)
  • Children 6-12 years old: 9-12 hours per 24 hours
  • Teenagers 13-18 years old: 8-10 hours per 24 hours

To promote better sleep habits in children, consider establishing a consistent bedtime routine, limiting screen time before bed, and creating a sleep-friendly environment that is dark, quiet, and cool.

The Role of Stress in Pediatric Hypertension

Stress can contribute to high blood pressure in children, just as it does in adults. Chronic stress can lead to consistently elevated blood pressure levels, potentially resulting in long-term health issues.

How can parents help children manage stress effectively? Here are some strategies:

  1. Encourage open communication about feelings and concerns
  2. Teach relaxation techniques such as deep breathing or mindfulness
  3. Ensure a balanced schedule with time for both activities and rest
  4. Promote regular exercise, which can help reduce stress
  5. Consider professional counseling if stress seems overwhelming

By helping children develop effective stress management skills early in life, parents can contribute to better blood pressure control and overall health.

Long-Term Implications of Childhood Hypertension

Untreated hypertension in children can lead to serious health complications in adulthood. Understanding these potential long-term effects underscores the importance of early detection and management.

What are the potential long-term consequences of untreated childhood hypertension? Some of the possible complications include:

  • Increased risk of heart disease and stroke in adulthood
  • Kidney damage or failure
  • Vision problems, including retinopathy
  • Cognitive impairment and learning difficulties
  • Persistent hypertension in adulthood

By addressing high blood pressure early in life, these risks can be significantly reduced, promoting better health outcomes throughout the child’s lifespan.

The Role of Genetics in Pediatric Hypertension

Genetic factors play a significant role in determining a child’s risk of developing hypertension. Children with a family history of high blood pressure are more likely to develop the condition themselves.

How does genetic predisposition influence blood pressure in children? Several mechanisms are involved:

  • Inherited traits affecting sodium sensitivity
  • Genetic variations in the renin-angiotensin-aldosterone system, which regulates blood pressure
  • Inherited tendencies towards obesity or diabetes, which can indirectly affect blood pressure

While genetic predisposition cannot be changed, awareness of family history can lead to earlier screening and preventive measures. It’s important for parents to share their family medical history with their child’s pediatrician to ensure appropriate monitoring and care.

Innovative Approaches to Managing Pediatric Hypertension

As our understanding of pediatric hypertension grows, new approaches to management and treatment are being developed. These innovative strategies aim to improve outcomes and quality of life for children with high blood pressure.

What are some emerging approaches in managing pediatric hypertension? Some promising areas include:

  • Telemedicine for remote blood pressure monitoring and management
  • Mobile apps to track diet, exercise, and blood pressure readings
  • Personalized medicine based on genetic profiles
  • Novel pharmaceutical approaches with fewer side effects
  • School-based interventions for education and screening

While many of these approaches are still in development or early stages of implementation, they offer hope for more effective and tailored management of hypertension in children.

The Importance of a Multidisciplinary Approach

Managing pediatric hypertension often requires a team effort. A multidisciplinary approach involving various healthcare professionals can provide comprehensive care and support for children with high blood pressure and their families.

Who might be involved in a child’s hypertension management team? Depending on the child’s specific needs, the team may include:

  • Pediatrician or family doctor
  • Pediatric cardiologist
  • Pediatric nephrologist (kidney specialist)
  • Registered dietitian
  • Exercise physiologist
  • Child psychologist or counselor
  • School nurse

This collaborative approach ensures that all aspects of the child’s health are addressed, from medical management to lifestyle modifications and emotional support.

Empowering Children in Their Health Journey

While parents and healthcare providers play crucial roles in managing pediatric hypertension, involving children in their own health management can lead to better outcomes and foster a sense of responsibility for their well-being.

How can parents and healthcare providers empower children to take an active role in managing their blood pressure? Here are some strategies:

  1. Education: Explain hypertension in age-appropriate terms and why managing it is important
  2. Involvement in decision-making: Allow children to make choices about their diet and physical activities within the recommended guidelines
  3. Goal-setting: Help children set achievable health goals and celebrate their progress
  4. Self-monitoring: Teach older children how to use blood pressure monitors and keep logs
  5. Positive reinforcement: Praise efforts and achievements in managing their health

By empowering children to take an active role in their health, we can help them develop lifelong habits that promote cardiovascular health and overall well-being.

High Blood Pressure in Kids – Children’s Health

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You may think that hypertension, or high blood pressure, is a condition that affects only adults. However, according to the American Academy of Pediatrics (AAP), an estimated 3.5% of children and teens have high blood pressure. When left untreated, this condition can cause serious complications, such as heart disease, kidney failure, stroke and vision loss.

“A blood pressure reading measures the force of blood against the walls of arteries. This pressure is what your heart has to pump against to get blood out to the rest of your body,” explains Alan Sing, M.D., a pediatric cardiologist at Pediatric Heart Specialists, a Children’s Health℠ Care Network Partner. “If blood pressure is higher, then the heart has to work harder. Over time, this high blood pressure can cause damage to different organ systems in the body.”

However, regular screenings can help identify high blood pressure in children. Learn more about what is considered high blood pressure for a child and ways you can help keep your child healthy.

How is a child’s blood pressure checked?

A child’s blood pressure should be checked once a year at their annual exam starting at the age of 3. Your child should sit comfortably in a chair with their feet supported and their arm level with their heart. Your child’s physician or nurse will use a stethoscope and a hand-inflated arm cuff to check their blood pressure.

If a child has a health condition that increases their risk for high blood pressure, such as obesity or kidney disease, their blood pressure will be checked at every doctor visit. If a child’s blood pressure is high at a well-child visit, their blood pressure will also be checked more frequently.

Your child’s pediatrician will track trends in blood pressure over time, not just the initial screening, to accurately identify a diagnosis of hypertension.

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 (top number) between 120-129 mm Hg and diastolic (bottom number) 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 (called an ambulatory blood pressure monitor or ABPM). 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.

This monitor can help your child’s pediatrician decide whether your child needs further tests or treatment by giving a complete picture of blood pressure throughout the day and night.

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.

What are causes of high blood pressure in kids?

A child’s blood pressure might be high when it is measured for many reasons, such as stress, illness, recent physical activity, a true hypertension issue or a medical condition.

Causes of high blood pressure in kids can include:

  • Obesity or being overweight
  • High-sodium diet (too much salt)
  • Kidney disease
  • Congenital or acquired heart disease
  • Thyroid or adrenal disease
  • Diabetes
  • Genetic disorders (inherited from a parent or grandparent)
  • Stress

When a young child (under 6) has high blood pressure, the cause is often a related medical condition, such as kidney disease. This is called secondary hypertension.

When high blood pressure has no disease-related cause, it’s called primary hypertension. Primary hypertension is more common in older children and teens and is commonly related to obesity or to a family history of hypertension.

“There is a growing trend in the number of children and teens who are overweight or have obesity, and this is a major cause of high blood pressure in kids,” says Smitha Vidi, M.D., a pediatric nephrologist at Children’s Health and Assistant Professor at UT Southwestern. “Additionally, kids are eating a lot of processed foods, which have very high amounts of salt. A high-salt diet is a big contributor to increasing blood pressures.”

How is high blood pressure treated in children?

If your child is diagnosed with hypertension, your pediatrician may recommend certain lifestyle changes to lower their blood pressure, such as a healthy diet, regular exercise or weight loss.

  • DASH diet: Designed from research sponsored by the National Institutes of Health, the DASH diet focuses on eating fruits, vegetables, low-fat dairy, nuts, beans and seeds.
  • Exercise: The AAP recommends children and adolescents get 60 minutes or more of physical activity daily (includes outside play and team sports).
  • Low-sodium diet: Sodium is the scientific name for the salt in food. In addition to watching table salt usage, be cautious of how much processed food your child eats.

If needed, your child’s physician may prescribe medications to control blood pressure. These medicines are the same ones adults take, just in age and weight-appropriate doses. Your child’s physician can choose the best medication for your child based on their individual health profile and risk factors.

You can help your child prevent high blood pressure and complications. Talk about the importance of a healthy lifestyle and continue to be a good role model – making healthy food choices and engaging in exercise as a family.

“Taking steps as a family to stay healthy is key to preventing hypertension in children,” says Dr. Vidi. “Try to devote a little of your time each day to doing fun activities with your kids, such as biking, dancing, swimming or even walking to a nearby park.

Learn more

No matter the reason behind a child having high blood pressure, Children’s Health can provide expert, multidisciplinary care. Learn more about hypertension in kids and how we can help.

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Data table for chart 1

Table summary

This table displays the results of Data table for chart 1 Normal and Borderline or elevated, calculated using percent units of measure (appearing as column headers).
 NormalBorderline or elevated
percent
Total6 to 11 years919
12 to 19 years94. 85,2Note E: Use with caution
Boys6 to 11 years92.77.3
12 to 19 years93.75,3Note E: Use with caution
Girls6 to 11 years89.110.9
12 to 19 years95.94,1Note E: Use with caution


Data table for chart 2

Table summary

This table displays the results of Data table for chart 2 Thinness/normal weight, Overweight and Obese, calculated using mmHg units of measure (appearing as column headers).
 Thinness/normal weightOverweightObese
mmHg
Total6 to 11 years9396100
12 to 19 years96101103
Boys6 to 11 years9295100
12 to 19 years97102106
Girls6 to 11 years9396101
12 to 19 years9699100


Data table for chart 3

Table summary

This table displays the results of Data table for chart 3 Thinness/normal weight, Overweight and Obese, calculated using mmHg units of measure (appearing as column headers).
 Thinness/normal weightOverweightObese
mmHg
Total6 to 11 years616265
12 to 19 years616264
Boys6 to 11 years616165
12 to 19 years616364
Girls6 to 11 years616265
12 to 19 years616264


Table

The criteria for blood pressure classification in adults are as follows:

Table summary

This table displays the results of The criteria for blood pressure classification in adults are as follows:. The information is grouped by Category (appearing as row headers), Description (appearing as column headers).
CategoryDescription
Ages 6 to 17Note 2Ages 18 and 19Note 3
NormalSBP and DBP < 90th percentileMean SBP/DBP < 120/80 mmHg
BorderlineSBP or DBP ≥ to the 90th percentile, but < the 95th percentile OR
Measured mean SBP/DBP > 120/80 mmHg
Mean SBP of 120-139 mmHg and mean DBP of 80-89 mmHg OR
Mean SBP of 120-139 mmHg and mean DBP Mean SBP
ElevatedSBP or DBP ≥ 95th percentile OR
Respondent reported using blood pressure medication within the past month
Mean SBP/DBP of ≥ 140/90 mmHg OR
Respondent reported using blood pressure medication within the past month

Age

Systolic (upper) indicator

Diastolic (lower) indicator

Maximum value

Maximum value

Maximum value

Maximum value

Newborns

From 60

Up to 96

From 40

Up to 50

2 months-year

From 80

Up to 112

From 50

Up to 74

1-2 years

From 82

To 115

From 61

Up to 75

2-3 years

From 85

Up to 116

From 60

Up to 76

3-4 years

From 90

Up to 118

From 60

Up to 78

4-5 years old

From 95

Up to 120

From 60

Up to 80

5-6 years old

From 100

Up to 122

From 60

Up to 80

6-8 years

From 110

Up to 122

From 70

Up to 82

8-11 years old

From 110

Up to 126

From 70

To 82

12-15 years old

From 110

Up to 136

From 70

Up to 86

15-16 years old

From 110

Up to 136

From 70

Up to 90

16-18 years old

From 110

Up to 120

From 80

Up to 90