Hypertension is a health complication that one usually associates with advancing age and adult life stresses. Hypertension is a sustained elevation in blood pressure. This means it is diagnosed when one’s blood pressure is higher than normal on repeated measurements over a particular period.
It is a scientific fact that in childhood and adolescence, blood pressure normally increases with age and height. So, a normal blood pressure value for your child will change each year, just as the normal values for their height and weight change.
You will be shocked to know that paediatric hypertension (or high blood pressure among children) is on the rise. According to Johns Hopkins Medicine, over the last 30-40 years, paediatric hypertension in the United States has increased fourfold.
The study says that currently up to 4.5%, or 3.34 million, of children in the United States have this condition. Recent statistics on heart disease and stroke put out by the American Heart Association suggest the number could be higher, estimating that 15% of adolescents have abnormal blood pressure.
ABP Live spoke to Dr Kanav Anand, a paediatric nephrologist at Sir Ganga Ram Hospital in New Delhi, to gain insights into what can cause hypertension in children and what parents should watch out for. Dr Kanav Anand was honoured with the Dr A P J Abdul Kalam Health Award in 2024 for his contribution to and Excellence in the Field of Child Kidney Care (paediatric nephrology).
Here are the excerpts from an exclusive interaction with Dr Anand.
ABP: How common is the problem of hypertension among children?
Dr Kanav Anand: You will be surprised to know that approximately 2-5% of children suffer from hypertension. What’s worse is that the majority is not even aware that they have this problem. A rise in the incidence of hypertension has been linked to the concurrent increase in obesity. The prevalence of hypertension in obese children is higher and ranges from 10%-30%.
ABP: Should all children get their blood pressure checked?
Dr Kanav Anand: Children, aged more than 3 years, who suffer from cold, cough or fever should have their blood pressure measured. Children aged less than 3 years should have their BP checked if they have:
- History of low birth weight, prematurity or requirement of neonatal intensive care.
- History of heart disease at birth
- History of recurrent urinary tract infection
- History of blood or protein loss in urine
- History of any kidney disease in the past
- Family history of kidney disease
- History of organ transplantation
- History of receiving medicines which can cause high blood pressure/kidney damage
ABP: What are the symptoms of hypertension in kids?
Dr Anand: The usual symptoms of hypertension are headache (sometimes throbbing), flushing, giddiness, bleeding from the nose, vision disruptions, poor school performance, irritability, blood or protein in urine, passing urine more or less frequently and unexplained weight loss. In some cases, hypertension can be without symptoms, and therefore, those children who are obese, have a history of neonatal intensive care stay, or have kidney/ heart disease or cardiac disease should have their blood pressure checked.
ABP: What are the causes of hypertension in children?
Dr Anand: In a majority of children, an underlying cause of hypertension can be identified. This includes problems in kidney, heart, blood vessels, hormones, or tumours, etc. Diseases of the kidney are the most common cause of hypertension in children. Primary or essential hypertension, commonly seen in adults, is becoming common in children, who are obese or overweight.
ABP: What happens if hypertension in children is not detected or not treated properly?
Dr Anand: If hypertension continues unchecked, it worsens over the years. The prolonged additional pressure in the blood vessels can lead to heart failure, stroke, damage to the eyes and kidneys.
ABP: How is hypertension in children treated?
Dr Anand: Most children with essential hypertension require lifestyle modifications, which include weight reduction, meditation, yoga, exercise, and low salt diet (<3.5 gm/day). Other risk factors like smoking, alcohol, steroids, oral contraceptives, and sleep apnoea should also be controlled. For secondary hypertension, surgery helps in certain cases. For instance, if any tumour is causing hypertension, it needs to be removed surgically.
ABP: What are the advantages of early detection of high blood pressure in children?
Dr Anand: Timely detection helps in appropriate treatment of hypertension and its cause and helps to prevent end-organ damage in adult life.
In case a child in the family is diagnosed with hypertension, do not panic. See the appropriate doctor and start treatment immediately. It does not mean the child would be stuck with medications for the entire life, says the Boston Children’s Hospital website. If your child has 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.
Kirti Pandey is a senior independent writer.
[Disclaimer: The information provided in the article, including treatment suggestions shared by doctors, is intended for general informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition.]
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