High blood pressure in kids

You may think that hypertension, or high blood pressure, is a condition that affects only adults. However, according to the American Academy of Pediatrics (AAP), an estimated 3.5% of children and teens have high blood pressure. When left untreated, this condition can cause serious complications, such as heart disease, kidney failure, stroke and vision loss.

"A blood pressure reading measures the force of blood against the walls of arteries. This pressure is what your heart has to pump against to get blood out to the rest of your body," explains Alan Sing, M.D., a pediatric cardiologist at Pediatric Heart Specialists, a Children's Health℠ Care Network Partner. "If blood pressure is higher, then the heart has to work harder. Over time, this high blood pressure can cause damage to different organ systems in the body."

However, regular screenings can help identify high blood pressure in children. Learn more about what is considered high blood pressure for a child and ways you can help keep your child healthy.

How is a child's blood pressure checked?

A child's blood pressure should be checked once a year at their annual exam starting at the age of 3. Your child should sit comfortably in a chair with their feet supported and their arm level with their heart. Your child's physician or nurse will use a stethoscope and a hand-inflated arm cuff to check their blood pressure.

If a child has a health condition that increases their risk for high blood pressure, such as obesity or kidney disease, their blood pressure will be checked at every doctor visit. If a child's blood pressure is high at a well-child visit, their blood pressure will also be checked more frequently.

Your child's pediatrician will track trends in blood pressure over time, not just the initial screening, to accurately identify a diagnosis of hypertension.

What is a normal blood pressure for a child?

There isn't one single number or blood pressure that is considered normal for all children. A healthy blood pressure for a child depends on their age, height and gender.

For children under the age of 13, your pediatrician will use a percentile chart to compare your child's blood pressure to peers of the same age, height and gender. This allows a more precise indication if a young child is showing high blood pressure. A child is considered to have an elevated blood pressure if their blood pressure falls above the 90th percentile, and hypertension if they are above the 95th percentile.

Over the age of 13, normal blood pressure ranges are the same for teenagers as they are for adults:

• Normal blood pressure: Less than 120/80 mm Hg
• Elevated blood pressure: Systolic (top number) between 120-129 mm Hg and diastolic (bottom number) less than 80 mm Hg
• Hypertension: Top or bottom number higher than 130/80 mm Hg

If your child's pediatrician notices a trend of high blood pressure readings, they will closely monitor your child's blood pressure or refer you to a specialist to address any health concerns. They may have your child wear a 24-hour, portable blood pressure monitoring device (called an ambulatory blood pressure monitor or ABPM). This can be worn at home during your child's normal routine and takes measurements every 20 to 30 minutes during the daytime and 30 to 60 minutes at night.

This monitor can help your child's pediatrician decide whether your child needs further tests or treatment by giving a complete picture of blood pressure throughout the day and night.

What are signs of high blood pressure in kids?

Hypertension is often a silent condition. Typically, there aren't obvious symptoms to let parents know their child has high blood pressure; it is often diagnosed when the doctor discovers it during an exam. This is why regular blood pressure screening is so important.

Some children with high blood pressure may experience frequent headaches, changes in vision or dizziness. If your child complains of these symptoms, contact your pediatrician.

What are causes of high blood pressure in kids?

A child's blood pressure might be high when it is measured for many reasons, such as stress, illness, recent physical activity, a true hypertension issue or a medical condition.

Causes of high blood pressure in kids can include:

• Obesity or being overweight
• High-sodium diet (too much salt)
• Kidney disease
• Congenital or acquired heart disease
• Thyroid or adrenal disease
• Diabetes
• Genetic disorders (inherited from a parent or grandparent)
• Stress

When a young child (under 6) has high blood pressure, the cause is often a related medical condition, such as kidney disease. This is called secondary hypertension.

When high blood pressure has no disease-related cause, it's called primary hypertension. Primary hypertension is more common in older children and teens and is commonly related to obesity or to a family history of hypertension.

"There is a growing trend in the number of children and teens who are overweight or have obesity, and this is a major cause of high blood pressure in kids," says Smitha Vidi, M.D., a pediatric nephrologist at Children's Health and Assistant Professor at UT Southwestern. "Additionally, kids are eating a lot of processed foods, which have very high amounts of salt. A high-salt diet is a big contributor to increasing blood pressures."

How is high blood pressure treated in children?

If your child is diagnosed with hypertension, your pediatrician may recommend certain lifestyle changes to lower their blood pressure, such as a healthy diet, regular exercise or weight loss.

• DASH diet: Designed from research sponsored by the National Institutes of Health, the DASH diet focuses on eating fruits, vegetables, low-fat dairy, nuts, beans and seeds.
• Exercise: The AAP recommends children and adolescents get 60 minutes or more of physical activity daily (includes outside play and team sports).
• Low-sodium diet: Sodium is the scientific name for the salt in food. In addition to watching table salt usage, be cautious of how much processed food your child eats.

If needed, your child's physician may prescribe medications to control blood pressure. These medicines are the same ones adults take, just in age and weight-appropriate doses. Your child's physician can choose the best medication for your child based on their individual health profile and risk factors.

You can help your child prevent high blood pressure and complications. Talk about the importance of a healthy lifestyle and continue to be a good role model – making healthy food choices and engaging in exercise as a family.

"Taking steps as a family to stay healthy is key to preventing hypertension in children," says Dr. Vidi. "Try to devote a little of your time each day to doing fun activities with your kids, such as biking, dancing, swimming or even walking to a nearby park."

Learn more

No matter the reason behind a child having high blood pressure, Children's Health can provide expert, multidisciplinary care. Learn more about hypertension in kids and how we can help.