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Guidelines Changed for Dealing with Children’s High Blood Pressure

The American Academy of Pediatrics releases new recommendations on how to diagnose and treat hypertension in children.

high blood pressure

For the first time since 2004, the American Academy of Pediatrics (AAP) has updated its guidelines for identifying and treating high blood pressure in children.

Committee members reviewed approximately 15,000 new research articles published during the past 13 years in order to craft their recommendations.

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“Prevention and early detection are key,” Dr. Joseph Flynn, co-chair for the AAP’s subcommittee on screening high blood pressure in children, said in a press statement. “High blood pressure levels tend to carry into adulthood, raising the risks for cardiovascular disease and other problems. By catching the condition early, we are able to work with the family to manage it, whether that’s through lifestyle changes, medication, or a combination of treatments.”

The prevalence of high blood pressure, or pediatric hypertension in children, has increased in the United States since 1988.

Researchers estimate that about 3.5 percent of all children and adolescents have the condition. However, rates of pediatric hypertension have plateaued in recent years.

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Obesity has a well-established relationship with hypertension, and while it may not be the only contributing factor, it is certainly the primary one.

The “increase in abnormal blood pressure in children and adolescents since 2004 correlates very well with the worsening pediatric obesity over this period,” Dr. David Kaelber, a co-chair on the AAP subcommittee, told Healthline.

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“Actually because the prevalence of pediatric obesity has been leveling off in the last couple years we are also seeing a leveling off of increasing high blood pressure in children and adolescents as well,” he said.

A serious health issue

Pediatric hypertension remains a serious issue because it may often be overlooked in children and adolescents, particularly if they are athletic.

As Healthline reported in May, a study concluded that undiagnosed hypertension in children and young adults leaves them at risk for future artery stiffening.

That can lead to increased risk of heart attack and stroke, as well as having damaging effects on organs throughout the body.

Young people with hypertension tend to carry the condition into adulthood, so risk continues to increase with age.

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“Young people with elevated blood pressure — even those with only a high systolic number, but normal diastolic number — may have an abnormally stiff aorta, which should not be ignored,” Dr. Wanpen Vongpatanasin, lead author of the study, told Healthline. “They should have close follow-up and talk with their primary care physicians to see if their condition needs to be treated.”

How to avoid high blood pressure

High blood pressure can be treated with drugs, but, doctors say, the first line of defense is lifestyle changes.

This includes diet and exercise to help lose weight. Salt intake is another important factor for blood pressure, so parents should be aware of what their kids are eating.

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The AAP recommends that if lifestyle changes are not enough to lower blood pressure, or if the child has another condition such as diabetes, then medication should be used.

“These guidelines offer a renewed opportunity for pediatricians to identify and address this important — and often unrecognized — chronic disease in our patients,” Kaelber said in a press statement.

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