By Connie Crawley
University of Georgia
The U.S. Department of Health and Human Services recommends that children over age three be screened for hypertension whenever they have a check-up. Younger children may need to be screened earlier if they have health problems.
The blood-pressure cuff put around the child’s arm must be the right size for the measurement to be correct. Also, the child or teen should sit quietly for five minutes with their back and feet supported and their right arm resting at heart level before being checked. This may be challenging in younger children.
The health care provider will decide if your child’s blood pressure is normal by looking at a chart that shows normal and abnormal values based on gender, age and height. What is normal for an adult may not be normal for a child.
For example, a six-year-old boy who is average height with a systolic pressure of 121 mm Hg and a diastolic pressure of 82 mm Hg would be diagnosed with high blood pressure and would probably need medicine and lifestyle changes. In contrast, a similar reading in an adult would be diagnosed as pre-hypertension and only require lifestyle changes.
If your child or teenager has a high reading during a doctor visit, have it rechecked twice to be sure it is right. If it continues to be high, other tests may be needed to find out what is causing it.
A few children have “white coat” hypertension. This means they get so anxious when having a check-up that their blood pressure soars. For these children, wearing a special blood-pressure monitor continuously for a while may show this is the case. But some children and teens really do have high blood pressure.
Depending on how high it is, they may just need changes in diet or activity, or they may need medicine. Some children also need treatment for other health problems like heart disease or kidney problems that are causing the high readings.
For anyone with hypertension, weight control is essential. For overweight or obese children and teens, a doctor may recommend they lose some weight or they keep their weight stable while they get taller. A registered dietitian or clinic that specializes in weight control for children and teens may be helpful.
Recommended lifestyle changes include limiting portion sizes, eating more fruits and vegetables, having fewer sweet drinks, eating fewer high-calorie and salty snacks, eating out less, switching to non-fat or low-fat dairy foods and consuming breakfast regularly.
Decreasing computer and TV time to less than two hours a day is important along with increasing physical activity to 30 or 60 minutes per day. These changes are good for the entire family since high blood pressure and related chronic diseases tend to be inherited.
In overweight kids, the health care provider may want to make sure they do not have high blood cholesterol and high blood glucose, or sugar. High blood pressure is often found with both of these conditions.
The doctor may check the child or teen from head to toe to make sure there are no other health problems related to high blood pressure. Surprisingly, they may ask about the child’s sleeping habits. Snoring and inadequate sleep may show that the child or teen has sleep apnea that is causing the problem.
(Connie Crawley is a Cooperative Extension nutritionist with the University of Georgia College of Family and Consumer Sciences.)