Children just like adults can develop high blood pressure as mentioned in the medical community-Hypertension. Hypertension is basically an elevation of blood pressure, there are 2 readings one during the contraction of the heart, which is called systolic; and one during the relaxation of the heart-diastolic. An average blood pressure in adults is 120/80 mmHg. However, in children, these numbers are lower are not as generically applied. That is, in children, the average blood pressure is usually based on the age, gender, and height and weight, which could range from an average blood pressure of 80/50 to 100/70 and even many more permutations.
In any case, like adults, children can also develop hypertension. However, that is the only similarity as the causes of hypertension vary dramatically between children and adults. For example, in adults, most of the causes of hypertension relate to the fact that as adults age, they gain weight, they smoke and drink alcohol and the blood vessels over time get abused and diseased to a point where they become stiffer and less resilient, which causes the elevation of blood pressure. The latter is called essential or primary hypertension. However, in children, that is not the case and the cause of hypertension is usually due to some other pathology; in most cases, that tends to be a renal cause, which I will discuss below. This type of hypertension in children is termed secondary hypertension.
About 2% of the pediatric population have hypertension with renal disease being the most common reason for the hypertension, which include: congenital renal structural disorders, renal artery stenosis (narrowing of the renal arteries), renal parenchymal disease, and renal inflammatory disease. As adolescents become more obese, they are starting to develop essential hypertension that is seen in adults. Other risk factors of hypertension in children are pregnant women who develop gestational diabetes and hypertension are more likely to have children with hypertension. It has also been theorized that women who breastfeed have lower rates of hypertension.
The diagnostic work up for children with suspected hypertension should focus on the kidneys, which would include a urinalysis, complete blood count, an electrolyte panel, as well as an echocardiogram, electrocardiogram, and chest X Ray. Also, one could also consider a renal ultrasound with color doppler to evaluate for renal artery stenosis.
The treatment of hypertension in children is not much different than adults, except, there is less a choice of drug to pick from as the side effects in children are more than in adults. Thus, one of the best medications to use for hypertension in children would be a calcium channel blocker such as amlodopine or felodopine.
References:
National High Blood Pressure Education Program Working group on High Blood Pressure in Children and Adolescents: The Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents. Pediatrics 114:555, 2004.
