Pediatricians Issue New Guidelines For Identifying High Blood Pressure In Children


The American Academy of Pediatrics on Monday, Aug. 21, released new guidelines that can make it easier for pediatricians to identify children with high blood pressure.

Silent Condition

Hypertension is one of the leading causes of disease and disability in the United States.

High blood pressure is a silent condition because it does not often come with visible symptoms. It is, however, associated with long-term health consequences, which include cardiovascular disease and damage to organs such as the kidneys and the brain.

"More than 360,000 American deaths in 2013 included high blood pressure as a primary or contributing cause. That is almost 1,000 deaths each day," the U.S Centers for Disease Control and Prevention said.

The new guidelines, which aim to prevent high blood pressure in children, can help identify normal-range and high blood pressure in children.

Consequences Of High Blood Pressure In Childhood

The recommendations, set to be published in the journal Pediatrics next month, explain the association between hypertension in children and adults.

"It is not to be taken lightly that a child has high blood pressure," said Carissa Baker-Smith, from the University of Maryland Children's Hospital. "We know they have a greater likelihood of having high blood pressure as an adult and that's a risk factor for heart disease."

Hypertension tends to be more prevalent in overweight children. About 3.5 percent of teenagers and children have hypertension and most of those with the condition are overweight.

Updated Blood Pressure Tables And Routine Blood Pressure Measurements

The guidelines include new blood pressure tables that are based on children with normal weight for a more precise classification of hypertension. The 2004 guidelines included tables that outline ideal blood pressure readings but these were based on data that included some overweight kids who are likely to have higher blood pressure.

The guidelines recommend that pediatricians routinely take blood pressure measurements, and this is ideally done during the annual preventative care visits, which are more likely to indicate the actual blood pressure of the child than during sick visits.

The guidelines also recommend giving the child blood pressure lowering medications if lifestyle interventions did not work or if the child has other conditions such as diabetes. The guidelines likewise recommend confirmation of diagnosis.

"This is very important in children because there's a very high rate of what's called white coat hypertension, where blood pressure is high in the office (due to fear of doctors) but not at home," said Joseph Flynn, of the University of Washington.

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