Overview

High blood pressure (hypertension) in children is blood pressure that's the same as or higher than 95 percent of children who are the same sex, age and height as your child. There isn't a simple target blood pressure reading that indicates high blood pressure in all children because what's considered normal changes as children grow.

High blood pressure in children younger than 6 years old is usually caused by another medical condition. Older children can develop high blood pressure for the same reasons adults do — excess weight, poor nutrition and lack of exercise.

Lifestyle changes, such as eating a heart-healthy diet and exercising more, can help reduce high blood pressure in children. But for some children, medications may be necessary.

Symptoms

High blood pressure usually doesn't cause symptoms. However, signs and symptoms that might indicate a high blood pressure emergency (hypertensive crisis) include:

  • Headaches
  • Seizures
  • Vomiting
  • Chest pains
  • Fast, pounding, or fluttering heart beat (palpitations)
  • Shortness of breath

If your child has any of these symptoms, seek emergency medical care.

When to see a doctor

Your child's blood pressure should be checked during routine well-check appointments starting at age 3, and at every appointment if your child is found to have high blood pressure.

If your child has a condition that can increase the risk of high blood pressure — including premature birth, low birth weight, congenital heart disease and certain kidney problems — blood pressure checks might begin in infancy.

If you're concerned about your child having a risk factor for high blood pressure, such as being overweight or obese, talk to your child's doctor.

Causes

High blood pressure in younger children is often related to other health conditions such as heart defects, kidney disease, genetic conditions or hormonal disorders. Older children — especially those who are overweight — are more likely to have primary hypertension. This type occurs on its own, without an underlying condition.

Risk factors

Your child's risk factors for high blood pressure depend on health conditions, genetics and lifestyle factors.

Primary (essential) hypertension

Primary hypertension occurs on its own, without an identifiable cause. This type of high blood pressure occurs more often in older children, generally age 6 and older. The risk factors for developing primary hypertension include:

  • Being overweight or obese
  • Having a family history of high blood pressure
  • Having type 2 diabetes or a high fasting blood sugar level
  • Having high cholesterol
  • Eating too much salt
  • Being black or Hispanic
  • Being male
  • Smoking or exposure to second-hand smoke
  • Being sedentary

Secondary hypertension

Secondary hypertension is caused by another condition. It's more common in young children. Other causes of high blood pressure include:

  • Chronic kidney disease
  • Polycystic kidney disease
  • Heart problems, such as severe narrowing (coarctation) of the aorta
  • Adrenal disorders
  • Hyperthyroidism
  • Pheochromocytoma, a rare tumor in the adrenal gland
  • Narrowing of the artery to the kidney (renal artery stenosis)
  • Sleep disorders, especially obstructive sleep apnea
  • Certain medications, such as decongestants, oral contraceptives and steroids
  • Drugs, such as cocaine

Complications

Children who have high blood pressure are likely to continue to have high blood pressure as adults unless they begin treatment.

If your child's high blood pressure continues into adulthood, your child could be at risk of:

  • Stroke
  • Heart attack
  • Heart failure
  • Kidney disease

Prevention

High blood pressure can be prevented in children by making the same lifestyle changes that can help treat it — controlling your child's weight, providing a healthy diet and encouraging your child to exercise.

High blood pressure caused by another condition can sometimes be controlled, or even prevented, by managing the condition that's causing it.

Dec. 05, 2018
  1. Bakris GL, et al. Hypertension in children and adolescents. Hypertension: A Companion to Braunwald's Heart Disease. 3rd ed. Philadelphia, Pa.: Saunders Elsevier; 2018. https://www.clinicalkey.com. Accessed Nov. 16, 2018.
  2. Mattoo TK. Definition and diagnosis of hypertension in children and adolescents. https://www.uptodate.com/contents/search. Accessed Nov. 16, 2018.
  3. Rao G. Diagnosis, epidemiology and management of hypertension in children. Pediatrics. 2016;138:e20153616.
  4. Mattoo TK. Evaluation of hypertension in children and adolescents. https://www.uptodate.com/contents/search. Accessed Nov. 16, 2018.
  5. Flynn JT, et al. Clinical practice guideline for screening and management of high blood pressure in children and adolescents. Pediatrics. 2017;140:e20171904.
  6. AskMayoExpert. Diet and activity guidelines (child). Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2018.
  7. Reducing sodium in children's diets. Centers for Disease Control and Prevention. https://www.cdc.gov/vitalsigns/children-sodium/index.html. Accessed Nov. 17, 2018.

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