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Hypertension in Children
 Dr. Sushil Azad

Hypertension in Children

Hypertension means “high blood pressure.” Blood pressure is the force of blood as it flows through the body's vessels. In hypertension, the level of pressure is higher than normal. Most people think of high blood pressure as a condition that affects older people. But high blood pressure actually affects people of all ages - including young children. A recent study that looked at 15,000 adolescents found that nearly one in five had hypertension. There are reasons to believe that hypertension is vastly underdiagnosed in children, since:

  • It can be difficult to measure in infants and young children.
  • It’s sometimes challenging to identify.
  • It’s often thought of as not something that really affects kids.

While kids with hypertension are unlikely to have heart attacks and strokes, there’s also compelling evidence that it causes changes in the structures of the blood vessels, heart, kidneys, eyes and brain. Hypertension in children can either be Primary hypertension means that hypertension does not seem to be caused by any underlying medical condition or Secondary hypertension means there is underlying medical cause like kidney disease, endocrine cause, heart disease. In Younger children secondary hypertension is more common but as age increases ratio becomes 50/50. Risk factors for high blood pressure in children include obesity and a family history of high blood pressure. Other risk factors may include medical problems such as sleep apnea or other sleep disorders.
Obesity is considered the primary risk for high blood pressure in children. Not only does being obese put children at risk for high blood pressure, but also for a range of other health problems such as heart disease and diabetes. Obesity is a result of two important factors, first and foremost is quality and quantity of food and second is too little activity both of which are modifiable. In early stages of hypertension there may not be any symptoms but in advanced stages child can have headache, breathing problem, chest pain, and change in vision.
Secondary hypertension in some cases can be fixed like if it is caused by narrowing of one of the major arteries, certain endocrine causes or if it is caused by kidney inflammation. In primary hypertension early stages are managed by life style modification like changes in diet, exercise and weight loss which can significantly reduce the blood pressure. In advanced stages management usually involves addition of medications apart from life style modification which still remain of paramount importance.
While children with hypertension are more likely to have it as adults, it’s not necessarily always the case. This depends on factors including the cause of the hypertension and how it responds to treatment. In primary hypertension, appropriate lifestyle modifications may allow for medications to be stopped. In addition, if a secondary cause is identified and successfully treated, medications may not be necessary. So promoting healthy lifestyle choices and educating families to assist with appropriate dietary and activity choices to improve overall health and reduce the risk of hypertension.

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