High blood pressure in children

High blood pressure (hypertension) in children is blood pressure that is at or above the 95th percentile for children who are the same sex, age and height as your child. There isn't a simple target range for high blood pressure in all children because what's considered normal changes as children grow. However, in teenagers, high blood pressure is defined the same as for adults: A blood pressure reading greater than or equal to 130/80 millimeters of mercury (mm Hg).

The younger a child is, the more likely it is that the high blood pressure is caused by a specific and identifiable 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 low in salt (sodium) and exercising more, can help reduce high blood pressure in children. But for some children, medications may be necessary.

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 heartbeat (palpitations)
• Shortness of breath

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

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 soon after birth.

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

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 of high blood pressure occurs on its own, without an underlying condition.

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 children age 6 and older. The risk factors for developing primary hypertension include:

• Being overweight or having obesity
• 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 secondhand 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
• Overactive thyroid (hyperthyroidism)
• Narrowing of the artery to the kidney (renal artery stenosis)
• Sleep disorders, especially obstructive sleep apnea
• Certain drugs and medications, including those used to relieve a stuffy nose (decongestants), stimulants used to treat attention-deficit/hyperactivity disorder (ADHD), caffeine, nonsteroidal anti-inflammatory drugs (NSAIDs) and steroids
• Cocaine, methamphetamine and similar drugs

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

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 low in salt (sodium) 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.