Hypertension (high Bp)

Dr Kumud P Mehta
Consultant Pediatrician and Pediatric Nephrologist, B.J.Wadia Hospital for Children, Mumbai, India
First Created: 04/02/2001  Last Updated: 08/01/2015

Patient Education

My child aged 4 years was admitted to 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?

The 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 the 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 the 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 nonpharmacologic measures like weight reduction in obese children, diet control (low salt, high potassium, high calcium & magnesium, and low-fat diet), exercises-yoga, lifestyle 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 an 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 the 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.

Hypertension (High BP) Hypertension (High BP) https://www.pediatriconcall.com/show_article/default.aspx?main_cat=pediatric-nephrology&sub_cat=hypertension-high-bp&url=hypertension-high-bp-patient-education 2015-08-01
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