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We Don’t Really Talk About Kids’ Blood Pressure, Do We?

This American Heart Month (February), let’s talk about a heart-adjacent topic: blood pressure.

Blood pressure isn’t a topic that’s discussed very often in pediatrics – the way pediatric blood pressure varies by age, the factors that play a role in this vital sign, and implications of children’s hypertension for caregivers.

Blood pressure is the force with which blood is pumped throughout our bodies. It is measured via two numbers: the systolic (upper) and diastolic (lower) pressure, written as a fraction, one over the other. A normal reading for an adult over 20 years old is 120/80 or below. Typically, hypertension – or high blood pressure – is associated with adult medical conditions, but there are times when a child’s blood pressure can be elevated due to a variety of causes.

Differences in Pediatric Blood Pressure

The first thing to understand about blood pressure is that its normal rate varies based on age. A normal metric for a child is different from that of an adult, with the average increasing as kids get older. For instance:

If you measure your child’s blood pressure and find it outside the normal ranges, always recheck it. And make sure that the cuff you use is the right size, as this can affect the number as well. Do not rely on a blood pressure reading during times of pain or stress – these situations naturally lead to higher measurements and therefore aren’t necessarily a cause for alarm. If you think that your child is


showing up with elevated blood pressure, talk to their pediatrician.

Causes of Pediatric Hypertension

When it comes to reasons for pediatric hypertension, age is still a crucial factor. The younger the child, the more chance there is that their high blood pressure is secondary, meaning it is caused by another condition, such as kidney disease or heart complications as opposed to atherosclerosis. Certain medications and substances, like decongestants and stimulants, can also cause a high blood pressure reading.

As kids grow up, they can develop primary high blood pressure as a result of genes or lifestyle. Having a family history of hypertension increases the risk that a teen might also have it. Being overweight, having high cholesterol, eating a salt-heavy diet, smoking, and being sedentary can also contribute to high blood pressure in older children. The blood pressure screening that children receive at their well child visit is important, and most teenagers who are anxious at the visit can be talked through their stress to be able to achieve an accurate reading.

What Should I Do If My Child Has High Blood Pressure?

It’s worth repeating: if your child’s blood pressure reading is high, recheck it. Make sure that you are measuring at a time when they are not stressed or nervous to get the most accurate reading. Pediatric hypertension is not common, so make sure that the reading is right before taking any next steps.

If hypertension is truly a concern, your pediatrician will work with you to come up with a plan to determine the exact diagnosis. This often includes blood and urine tests, and possibly heart function tests, as well. If the hypertension is secondary, meaning that it is a symptom of another condition, the focus will likely be on treating whatever the other condition is. Once the source of the problem is under control, the blood pressure may stabilize as well.

If your child is older, they might have primary hypertension, similar to that experienced by adults. If this is the case, lifestyle changes to their activity level and diet could be needed. In more difficult cases, the doctor might recommend medication to get the blood pressure under control.

Being aware, knowing the signs, and keeping a cool head are the keys to facing any medical concern in our families. The blood pressure issue is no different. Pediatric hypertension is not common, thankfully, but it is something to watch out for and address appropriately if it comes up.