Management of Pediatric Hypertension

Hypertension, or high blood pressure, typically occurs in middle-aged adults. According to the International Pediatric Hypertension Association (IPHA), however, 5 percent of children have hypertension. Pediatric hypertension generally persists into adulthood. The effects of untreated hypertension on the heart and blood vessels also begin to appear in children with the disease. Treatment of pediatric hypertension involves implementing similar strategies to those administered to adults with the condition.

Causes

• Hypertension in adults may occur as "secondary hypertension," or high blood pressure caused by another condition such as kidney disease. In many cases, however, adult hypertension does not have a discernible cause. The IPHA notes that pediatric hypertension will more likely have an underlying cause than will adult hypertension. The American Heart Association (AHA) lists heart and kidney diseases as common causes of secondary hypertension in children. Some medications can also cause high blood pressure.

Detection

• The AHA points out that early detection of pediatric hypertension will improve children's health care. The organization recommends annual blood pressure screening for all children ages three and older. The IPHA suggests checking blood pressure whenever the child visits the doctor and more frequently if the child has symptoms of a causative disease. Obesity, high cholesterol and diabetes often occur in conjunction with pediatric hypertension. Because normal blood pressure in children increases with body size, doctors must interpret the blood pressure reading in light of the child's age and height, as well as sex. A study by Matthew Hanson published in "JAMA" in 2007 showed that many children with hypertension go undiagnosed.

Treat Underlying Conditions

• When health professionals diagnose pediatric hypertension, they should next screen for and treat causative conditions. Treating the disease usually resolves the hypertension. Health professionals should also screen for family history of hypertension, high cholesterol, diabetes and obesity. They and the child's parents might consider consulting a specialist in treating pediatric hypertension.

Lifestyle Modifications

• As with adults, health lifestyle habits can reduce high blood pressure in children. The National Heart Lung and Blood Institute (NHLBI) recommends that people of all ages strive to control their blood pressure by following a healthy diet, exercising regularly, maintaining a health weight and managing stress. A healthy diet means reducing the amount of salt, saturated fats and cholesterol one eats. These lifestyle modifications will also benefit conditions associated with hypertension, such as diabetes and high cholesterol.

Medications

• When hypertension does not have an underlying cause or goes unresolved, doctors will prescribe medications. The NHLBI lists nine categories of drugs that treat hypertension in adults, noting that most of these drugs will also reduce pediatric hypertension in a dose appropriate for children. Diuretics remove excess salt and fluid from the body, while beta-blockers reduce the heart rate and the force of heart beats. Many of the other categories of drugs relax or expand the blood vessels. Sometimes physicians will prescribe more than one drug to one patient.