Catching them young: Prevalence of hypertension in children
December 18, 2023
Hypertension or high blood pressure (BP) is a common condition that occurs when BP is consistently higher than 140/90 mmHg and is a risk factor for cardiovascular diseases and chronic kidney disease. Nearly 1.28 billion adults suffer from hypertension globally1. But did you know 1 in 25 teenagers aged between 12 to 19 years have hypertension, and 1 in 10 has elevated blood pressure2? A trend of rising prevalence of childhood hypertension has been observed in the past two decades3. In India, 7% of school-going children are hypertensive4.
What causes hypertension?
High BP in younger children is often linked to other health conditions like heart defects, kidney disease, genetic conditions, or hormonal disorders. Moreover, obesity is the primary risk factor for high BP in children. Hypertension is found among 4-14% of overweight children and 11–23% of obese children. Usually, high BP doesn’t cause symptoms but, in some cases, it may cause headaches, seizures, vomiting, chest pain, palpitations, and shortness of breath5. High BP during childhood increases the risk of high BP in adults, hence early diagnosis and intervention is essential6.
It can take several assessments to find out if a child has high BP. Healthcare providers usually measure BP with a cuff that wraps around the upper arm or the leg in babies. A child with average BP at or above the 95th percentile from multiple readings is considered to have hypertension7. American Academy of Pediatrics (AAP) recommends screening for hypertension annually in children starting at the age of 3 years by clinic BP measurements8. However, finding the right BP monitors for children remains challenging as most are not suitable for children. Using a cuff that is too narrow or too wide poses a probability of error in BP readings.
Treatment and management
Early detection and treatment are critical to reduce the burden and complications of hypertension and help children lead healthy lives. Treatment is directed towards identifying the underlying cause and instituting a heart-healthy lifestyle. Reducing salt intake and eating more fresh fruits and vegetables along with low-fat dairy products can help reduce BP. Moreover, encouraging an active lifestyle with less screen time and more physical activity is also recommended.
The prevention and management of hypertension in children and adolescents require greater importance in the public health agenda. Improved awareness, identification, management, and control of high BP are possible through policy action, awareness campaigns, and public health programmes. If they remain untreated, the hypertensive children of today will become the hypertensive adult population of tomorrow.