Hypertension (High BP/High Blood Pressure) in Children Causes, Treatment
HYPERTENSION (HIGH BP)
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Last Updated : 4/5/2010
Dr Kumud P Mehta
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My child aged 4 years was admitted in the hospital with convulsions recently. The doctor said that he had high blood pressure because of which he got a fit. Is it possible?
It is possible to get convulsions due to high BP and this episode is called hypertensive encephalopathy
which is due to increased intracranial pressure (increased pressure in the brain) or brain swelling due to high BP. Associated with convulsions the child may have paralysis of one side (hemiparesis), blindness and speech defect.

Is hypertension common in children? I through it occurred only in adults.
Hypertension through rare in children when compared with adults occurs in 1 - 2 % of school going children who look apparently healthy.

What is normal blood pressure in children?
Normal blood pressure in children varies according to age, gender and height of a child.

What are the causes of hypertension?
Cause of Hypertension in 80 - 85% of children are due to kidney diseases. Less than 5% are due to endocrinal (hormonal) disorders or tumors. Heart disease forms less than 3% hypertensives and rare cases of meningitis, encephalitis, brain tumors are other known causes. Less than 1 - 2% hypertensive children are due to essential or primary (cause unknown) hypertension in preadolescent age group.

How do I know whether my child is suffering from high BP?
Symptoms of hypertension are nonspecific in young children. Irritability, excessive crying, failure to gain weight, poor feeding, low-grade fever are the only symptoms in children younger than 2 - 3 years. Later on headache, vomiting, palpitations, giddiness, are present. In severe and acute cases (hypertensive crisis), signs and symptoms of encephalopathy (fits), cardiac failure (swelling over the body), blindness or renal failure occur which require hospitalization. BP recording is the only method by which hypertension is detected in children with vague symptoms.

What is the treatment for hypertension? When is treatment required?
Treatment of hypertension is urgently required to control BP in hypertensive emergencies to prevent damage to brain, heart, kidney and retina.
In cases with chronic hypertension which is moderate or severe, oral medicines are used depending on the cause. Chronic hypertension may require treatment for years.
Mild to moderate hypertension with minimum symptoms may be controlled by non pharmacologic measures like weight reduction in obese children, diet control (low salt, high potassium, high calcium & magnesium and low fat diet), exercises-yoga, life style modification, reduction of stress etc.

What are the complications of high BP?
Long term complications of hypertension are stroke, cardiovascular damage resulting in heart failure, renal failure and retinopathy or blindness.

Would my child require to take medicine for high BP life long?
Depending on the causes of hypertension and control of hypertension, the duration of drug treatment differs. Very few children with hypertension require life long treatment since Primary/Idiopathic/essential hypertension is rare in children. Familial hypertension can be recognized by BP recording of children whose parents suffer from high BP and non - pharmacologic therapy started at early stage.

Does any particular diet help in the treatment of high BP?
If high BP is due to essential hypertension with obesity- low salt, low fat, high fiber diet with high potassium, calcium and magnesium may help to reduce BP and also reduce the dose of drugs used for high BP.

What is the chance of hypertension in other members of the family if my child has high BP?
All children of hypertensive parents and all parents of hypertensive children should have BP recordings. Although mode of inheritance is not established, essential or primary hypertension is familial and environmental factors may play a role in developing high BP in susceptible individuals.

How do you follow up a patient of hypertension? How is the patient to be monitored?
Regular BP monitoring along with weight and height is the simple and easy method of following a patient with hypertension. Depending on the cause urinalysis, renal function tests etc may be needed during follow up.



Contributor Information and Disclosures

Dr Kumud P Mehta
Consultant Pediatrician and Pediatric Nephrologist, B.J.Wadia Hospital for Children, Mumbai, India


First Created : 4/2/2001
Last Updated : 4/5/2010

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