Pediatric Hypertension

High blood pressure—also known as hypertension—is often thought to be an adult problem. In recent years, there has been a rise in hypertension in children and adolescents. Today, obesity is the most common cause for hypertension in children and adolescents.

It’s important to have your child evaluated if he or she has been diagnosed with hypertension. Hypertension in children can lead to future health problems that may include kidney disease and even stroke and heart failure.

How do I know if my child has high blood pressure?

Your pediatrician will measure your child’s blood pressure at least once a year at your annual checkup.

There is not one number that indicates normal blood pressure for children. Instead, blood pressure in children is compared to other children who are the same age, gender, and height.

A blood pressure reading that places your child in the 90^th percentile or higher for children of similar age, gender, and height may mean that your child has hypertension. Your doctor will want to take at least three readings before diagnosing him or her with hypertension.

In some cases, a child’s blood pressure is high in a doctor’s office but then returns to a normal pediatric blood pressure at home. This is usually due to nervousness and is known as "white coat hypertension". Your doctor may arrange for a parent to measure blood pressure at home, or a school nurse. If the blood pressure reading remains high at home, your child will be referred to a specialist who can perform 24-hour ambulatory blood pressure monitoring and look for the cause of your child’s high blood pressure.

Symptoms of Pediatric Hypertension

Generally, high blood pressure does not cause symptoms in children. Symptoms that might mean a serious problem associated with high blood pressure include:

• Headaches
• Vomiting
• Chest pains
• Heart palpitations
• Shortness of breath
• Seizures

If your child has high blood pressure and is experiencing any of these symptoms, you should seek emergency care.

What causes high blood pressure in children?

There are two types of hypertension in children: primary and secondary

Primary hypertension is high blood pressure that develops on its own, without a specific cause. This type of hypertension is more common in older children. Primary hypertension is more likely to occur if your child:

• Is overweight
• Has a family history of high blood pressure
• Has high cholesterol
• Does not exercise

Secondary hypertension is more common in infants and younger children. This type of hypertension is caused by an underlying condition, such as:

• Chronic kidney disease
• Polycystic kidney disease
• Heart problems
• Hyperthyroidism
• Adrenal disorders
• Pheochromocytoma (a rare tumor in the adrenal gland)
• Renal artery stenosis (a narrowing of the artery to the kidney)
• Sleep disorders
• Some medications, including decongestants, oral contraceptives, and steroids

Why was my child referred to a nephrologist for high blood pressure?

Nephrologists are doctors who specialize in issues with the kidneys. Kidneys regulate blood pressure, and kidney disease is a common cause of high blood pressure in children. Our pediatric nephrologists have expertise with the treatment of all types of hypertension, including those that are caused by a kidney condition.

Can high blood pressure in children be prevented?

For most children, high blood pressure can be prevented through a healthy diet and exercise, and by keeping their weight at a healthy level. For children who have high blood pressure because of an underlying condition, the condition will need to be treated in order to lower blood pressure.