High Blood Pressure in Children

So, you thought that hypertension (high blood pressure) was a problem primarily for older adults, right? Think again. Although fewer than 5% of children and teens currently have been diagnosed with hypertension, soon you may hear about a startling increase in hypertension in these groups.

Why is this likely to happen? It used to be that guidelines for pediatricians suggested that they look closely at blood pressures in teens and children who were overweight or obese because these children were considered to be at risk for hypertension. Overweight children were considered to have hypertension if their pressures were elevated above the norm for their weight. But now, new guidelines published by the American Academy of Pediatrics encourage pediatricians to check pressures in all children, relying on data tables that include blood pressures for children of normal weight. No doubt, some normal weight children will now be diagnosed with hypertension as well. Furthermore, blood pressures of overweight and obese children will now look even worse, because normal weight childrenwho tend to have lower pressures on average. Add it all up and more children of all weights are likely to be diagnosed with (and probably treated for) hypertension.

Early diagnosis and treatment is good, right? Well, yes, if it decreases morbidity and/or mortality in these children later in life. The justification for treatment in children is the assumption that high blood pressure in a child will lead to high blood pressure and increased risk of morbidity/mortality as an adult. And that we can't know just yet, and probably won't for at least 20 years. Meanwhile, parents will stress out and health care costs will continue to rise....

It's an interesting risk/benefit conundrum. At least we know where pediatricians stand on this one.