30 Jul Why children should have their blood pressure checked?
High blood pressure is usually thought of as an adult health problem, but it can also affect children — often without obvious symptoms. Australia’s first guidelines for childhood hypertension aim to identify children at risk before it affects their heart, kidneys or long-term health.
High blood pressure can start in childhood
Most parents are familiar with checks for their child’s height, weight, hearing and eyesight. Blood pressure has received less attention because hypertension has traditionally been associated with adults.
However, evidence shows that blood pressure during childhood can follow a child into adulthood. Children and teenagers with high blood pressure are more likely to experience hypertension and cardiovascular problems later in life. Some children may also show early signs of strain on the heart or kidneys.
The new Australian guidelines were developed by the BPOzKids Network and Hypertension Australia, led by researchers from Murdoch Children’s Research Institute and Edith Cowan University. They are the first national guidelines specifically covering high blood pressure in children and adolescents.
Why checking blood pressure matters
High blood pressure is sometimes called a “silent” condition because children usually feel well and may have no symptoms.
Over time, consistently high pressure inside the blood vessels makes the heart work harder and can damage the heart, blood vessels and kidneys. It may also be a sign of an underlying condition, including kidney disease.
A single high reading does not mean a child has hypertension. Blood pressure can rise temporarily if a child is anxious, unwell, moving around or has just been active. The correct cuff size must also be used, and doctors will usually repeat the measurement before making a diagnosis.
When should children be checked?
The guidelines recommend routine blood pressure checks:
- once between the ages of seven and nine
- again between the ages of 13 and 15.
Children over three who have certain risk factors should be checked more regularly during healthcare visits.
Risk factors can include:
- overweight or obesity
- a family history of high blood pressure
- premature birth
- kidney, heart or hormonal conditions
- low levels of physical activity
- some medications.
Aboriginal and Torres Strait Islander children experience a higher burden of high blood pressure. The guidelines also recognise that children in rural and remote areas may have less access to screening and specialist care.
What happens if a reading is high?
The first step is usually to check the reading again. A GP may ask about the child’s health, birth history, diet, activity levels, medications and family medical history.
Some children may need home monitoring, a 24-hour blood pressure monitor, blood or urine tests, or referral to a specialist.
Treatment depends on the cause and severity. For many children, the first approach will involve family-based support with food choices, physical activity and salt intake. Medication may be needed when blood pressure remains high, there is evidence of organ damage or an underlying condition needs treatment.
Early support, not blame
High blood pressure is not always caused by a child’s weight or diet. Genetics, premature birth, medical conditions, medications and access to affordable food and healthcare can all play a part.
The value of checking is that it gives families and doctors time to investigate and act. A quick blood pressure reading may identify a health risk that could otherwise remain unnoticed for years.
For more information: Australia’s first guidelines to target high blood pressure in children
