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Hypertension Health Article

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Hypertension

Also known as high blood pressure, a condition in which too much force is exerted by the blood as it travels through the body's arteries.

There are two types of hypertension: primary and secondary. Primary, or essential, hypertension is caused by external factors; secondary hypertension is related to an underlying disorder, such as a congenital heart defect or kidney disease. Factors that increase the risk of high blood pressure include age (the likelihood of hypertension increases with age), race (hypertension is two to three times more common in blacks than in whites), heredity, and being overweight.

About 60 million Americans have high blood pressure. Of this number roughly 2.7 million are children between the ages of six and 17. Secondary hypertension occurs in only about 10% of the diagnoses—in the majority of cases the condition has no known cause. However, serious hypertension in infants and young children is usually of the secondary variety. Secondary hypertension also occurs (although less frequently) in adolescents, in whom it can signal a hormonal imbalance, kidney disorder, or other condition. In contrast, primary hypertension is not unusual among adolescents and is also found, though infrequently, in children. Of the two types, secondary hypertension is easier to detect because the symptoms of the underlying condition alert the child and parents that something is wrong. Primary hypertension usually produces no symptoms, a fact that makes it important for children to have their blood pressure tested regularly starting at the age of three. Children and adolescents with high blood pressure have an increased risk of developing hypertension in adulthood.

Blood pressure in children is measured the same way as in adults—with the familiar inflatable cuff and meter known as a sphygmomanometer (although a special smaller cuff is used for children). Two figures are used to describe blood pressure. The top figure—known as systolic blood pressure—refers to the level of pressure when the heart contracts to circulate the blood. The lower number—called the diastolic pressure—is based on the reading when the heart is resting. The total pressure is the systolic over the diastolic pressure, expressed in millimeters of mercury (a typical blood pressure reading might be 120 over 80). High blood pressure in adults is defined as a reading higher than 140 over 90. The blood pressure of children is lower than of adults and steadily increases as the child grows older. For example, a normal reading for a three-year-old would be 98 over 64. High blood pressure is diagnosed in children if the average of three readings is higher than that for 90% of children in the same age group. Aside from age, size itself is a factor—larger children have higher blood pressure than smaller ones, whatever their age (a fact taken in account when their blood pressure is assessed). Children should not have their blood pressure taken when they are nervous or agitated. Adolescents should be careful not to ingest any stimulants, such as caffeine, nicotine, or alcohol, in the hours preceding a blood pressure reading.

When a child is found to have elevated blood pressure, blood and urine tests and kidney χ rays are commonly taken to rule out any underlying disorder. If the diagnosis is primary hypertension, common treatment measures include a program of increased exercise and dietary modifications to cut down on sodium, especially salt, which is abundant in many foods favored by young people, such as french fries, pizza, potato chips, hot dogs, and hamburgers. Some substitution of healthy snacks such as fruit can help reduce the amount of salt in the diet. If the child is overweight, dietary changes may focus on weight loss. Even a modest reduction in weight can help reduce blood pressure. If other measures do not sufficiently alleviate the hypertension, a medication may be prescribed, usually a diuretic which cuts down on water retention by increasing the amount eliminated through urination.

For a child with a family history of heart disease or stroke, careful monitoring of blood pressure and treatment of hypertension can help reduce the risk of these conditions. According to the National High Blood Pressure Education Program, the treatment of hypertension early in life can also reduce the risk of heart and kidney failure and promote longevity. It is recommended that children and adolescents with high blood pressure have their blood pressure checked twice a year.

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