You may think of high blood pressure, or hypertension, as a risk factor for cardiac problems and stroke in adults. However, children — and even babies — can also have high blood pressure. Hypertension affects 10 to 15 percent of the school-age population, according to several studies. As with adults, obese children are more likely to have problems with hypertension.
 
High blood pressure in children can be caused by other diseases, such as diseases of the heart or kidney. (This is referred to as secondary hypertension.) For example, high blood pressure may be the first symptom of a congenital heart defect (a defect present at birth) called coarctation of the aorta, in which the main blood vessel leading away from the heart to the body is narrowed.

High blood pressure can also occur without any other known cause. (This is called primary or essential hypertension.) This is more likely to occur in older children, teenagers and adults. This kind of hypertension generally responds well to medications and may be helped with lifestyle changes such as increased exercise and an improved diet.

Many children seem to inherit a tendency for high blood pressure from one or both parents. In fact, children whose parents have high blood pressure are at greater risk for developing it — and they should be monitored. In other cases, high blood pressure may also be related to congenital heart disease.

Additionally, obesity contributes to high blood pressure in children. If your child is overweight, working with your pediatrician to help your child lose weight is important for that child’s long-term health. High blood pressure increases risk for heart attack, stroke and other cardiovascular problems in adulthood.

Symptoms of High Blood Pressure in Children

High blood pressure often has no symptoms. A blood pressure reading taken by a doctor may provide the first indication of the condition. It is also important to note that a normal blood pressure range for a child can vary significantly and depends on that child’s age, sex and height. When your pediatrician or another doctor checks your child’s blood pressure, you can ask if the readings are within a normal range based on those factors.

Typically, a high blood pressure reading on three separate occasions will prompt your child’s doctor to order an evaluation process. Sometimes nervousness and anxiety during examination may cause an increase in blood pressure that does not necessarily reflect persistent hypertension otherwise. This is sometimes called white coat hypertension — a term derived from the lab coats worn by many healthcare workers. The evaluation process may include a physical examination; blood and urine analysis; and non-invasive cardiac testing, which can help identify causes of high blood pressure. 

In some children— particularly young children — an evaluation of kidney function is done, as kidney problems are more frequently the cause of high blood pressure in young children compared to teenagers. The kidneys are one of the major regulators of blood pressure, so problems with the kidneys may result in high blood pressure.

Progression and Possible Complications of High Blood Pressure in Children

High blood pressure in children can lead to heart abnormalities. Like any muscle, the heart can get thicker if it has to work harder to generate a higher blood pressure. Enlargement of the heart’s lower left chamber, a condition called left ventricular hypertrophy, can be detected in 80 percent of children and young adult patients who have high blood pressure. Hypertension can also increase the risk of developing early coronary heart disease and stroke.

Treatments for High Blood Pressure in Children

The mild high blood pressure seen in most young patients can be controlled and even corrected through weight loss, reduction of salt intake and exercise training. These approaches are tailored to suit the needs of each patient.

Sometimes medications are needed to control high blood pressure. There are many types of antihypertensive medications, and your doctor will select the ones that are best for your child. Overall, these medications are very well tolerated by children, with few side effects.

If high blood pressure is caused by narrowing of the main body artery (coarctation of the aorta), this can be treated using catheter-based techniques or surgery. Even after successful surgery for coarctation of the aorta, many people will continue to have high blood pressure, though this is generally easily treated with medications.

If medicines are needed to control your child’s hypertension, it is very important that your child take these medications regularly so that even blood pressure control is maintained. If your child’s physician prescribes medicines to control high blood pressure, it is also still very important to continue to maintain heart-healthy lifestyle choices, such as regular exercise and a healthy diet.