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Children Blood Pressure

Children Blood Pressure

The normal range of children blood pressure  varies based on age, sex, and height percentile. Systolic blood pressure (the pressure when the heart beats) and diastolic blood pressure (the pressure between beats) steadily increase with age, but also shift based on the child’s height.

For children aged 1 to <13 years, normal blood pressure is defined as systolic and diastolic blood pressures below the 90th percentile for the child’s age, sex, and height. Elevated blood pressure is ≥90th to <95th percentile, stage 1 hypertension is ≥95th to <95th percentile+12 mmHg, and stage 2 hypertension is ≥95th percentile+12 mmHg.

For children ≥13 years, normal blood pressure is <120/<80 mmHg, elevated blood pressure is 120/<80 to 129/<80 mmHg, stage 1 hypertension is 130/80 to 139/89 mmHg, and stage 2 hypertension is ≥140/90 mmHg.

Some key normal blood pressure ranges by age:

  • Newborns up to 1 month: 60–90 mm Hg systolic, 20–60 mm Hg diastolic
  • Infants: 53–66 mm Hg diastolic, 87–105 mm Hg systolic
  • Toddlers: 95–105 mm Hg systolic, 53–66 mm Hg diastolic
  • Preschoolers: 95–110 mm Hg systolic, 56–70 mm Hg diastolic
  • Children in school: 57–71 mm Hg diastolic, 97–112 mm Hg systolic
  • Adolescents: 112–128 mm Hg systolic, 66–80 mm Hg diastolic

Elevated blood pressure readings should be repeated and confirmed over several visits before diagnosing hypertension in a child. The most precise measure is an average of multiple measurements taken over weeks or months by a health professional.

High blood pressure in Children

High blood pressure (hypertension) in children is defined as blood pressure that is at or above the 95th percentile for children of the same sex, age, and height. The normal range for blood pressure in children varies based on their age, sex, and height.

In teenagers, high blood pressure is defined the same as for adults: a systolic (top number) blood pressure greater than or equal to 130 mmHg or a diastolic (bottom number) blood pressure greater than or equal to 80 mmHg.

The causes of high blood pressure in children can include underlying medical conditions like

  • Heart defects
  • Kidney disease
  • Hormonal disorders especially in younger children

In older children, high blood pressure is more likely to be related to lifestyle factors like

  • Obesity
  • Poor diet
  • Lack of exercise

To diagnose high blood pressure in children, doctors will take multiple blood pressure measurements over time and compare them to normal ranges based on the child’s age, sex, and height. Treatment may involve lifestyle changes like weight loss, exercise, and a healthy diet low in sodium. In some cases, medication may also be necessary.

Monitoring and managing high blood pressure in children is important, as it can lead to serious health problems like heart disease and stroke if left untreated.

Low blood pressure in Children

Low blood pressure, or hypotension, is not as common in children as it is in adults, but it can still occur. Here are the key points about low blood pressure in children:

Low blood pressure in children is typically defined as a systolic (top number) reading below 90 mm Hg or a diastolic (bottom number) reading below 60 mm Hg. However, normal blood pressure ranges vary based on the child’s age, sex, and height.

Potential causes of low blood pressure in children include dehydration, certain medications, heart or hormone conditions, and severe infections or bleeding. Symptoms may include dizziness, lightheadedness, fatigue, nausea, and fainting.

If a child experiences symptoms of low blood pressure, it’s important to seek medical attention. The doctor will try to determine the underlying cause and may recommend treatments like increasing fluid intake, adjusting medications, or addressing any underlying medical conditions.

In many cases, low blood pressure in children is not dangerous and may simply be a normal variation. But it’s still important to monitor and address any concerning symptoms.

The key is working closely with the child’s pediatrician to ensure their blood pressure remains in a healthy range and any potential causes of low blood pressure are properly evaluated and managed.

How often is it appropriate to check a child’s blood pressure?

Children should have their blood pressure checked at regular well-child visits, typically starting at age 3. The frequency of blood pressure measurements depends on the child’s age and risk factors:

  • Healthy children with normal blood pressure should have it checked at least annually.
  • Children with elevated blood pressure or risk factors like obesity should have it checked more frequently, such as at every visit.
  • Children with confirmed hypertension should have their blood pressure monitored closely, with measurements taken at multiple visits to establish a diagnosis.

The American Academy of Pediatrics recommends measuring blood pressure by auscultation (using a stethoscope) on the right upper arm, using an appropriately sized cuff, at 3 different visits to confirm an elevated reading. Some organizations also suggest using ambulatory blood pressure monitoring (ABPM) to confirm hypertension in children.

In addition to routine well-child visits, blood pressure should be checked if a child feels dizzy, lightheaded, or has headaches. Measurements should be taken with the child seated and rested, with the arm supported at heart level. Proper technique and using the right cuff size is important for accurate readings.

How to check Bp in kids?

Blood pressure in children is checked using a blood pressure cuff and stethoscope, either manually or with an automatic device. Here are the key steps:

  • Use a cuff that fits the child’s arm properly. The cuff should be snug but allow room for 2 fingers under it.
  • Have the child sit quietly for 3-5 minutes before the measurement.
  • Support the child’s arm at heart level. The child’s legs should be uncrossed.
  • For manual readings, place the stethoscope over the artery in the elbow crease. Inflate the cuff to 20-30 mmHg above the expected systolic pressure, then slowly release the air. Note the systolic pressure (first sound) and diastolic pressure (last sound).
  • For automatic devices, the cuff inflates and deflates automatically, displaying the systolic and diastolic readings.
  • Take 3 measurements with 1-2 minutes between them. Use the average of the 3 readings.
  • Write down the date, time, blood pressure, and whether any medication was given.

Expert groups recommend checking blood pressure at every routine doctor visit starting at age 3. If the reading is high, wait 20-30 minutes and check again. If still high, give any prescribed “as needed” medication. Call the doctor if the blood pressure does not come down within 45 minutes.

What are children’s untreated high blood pressure’s long-term effects?

The long-term effects of untreated high blood pressure in children can be serious and include:

  • Damage to organs like the heart, kidneys, and eyes over time, as the heart has to work harder to pump blood against the higher pressure
  • Increased risk of heart disease, kidney failure, stroke, and vision loss later in life
  • Decreased cognitive function and academic performance, with studies showing children with hypertension scoring lower on tests of memory, attention, and concentration compared to normotensive children
  • Higher likelihood of developing conditions like ADHD, oppositional defiant disorder, depression, and anxiety
  • Persistence of high blood pressure into adulthood, increasing the risk of complications at an earlier age
  • Potential for accelerated atherosclerosis (hardening of the arteries) starting in childhood

The effects can be subtle at first, with no obvious symptoms, but over time untreated hypertension can lead to significant organ damage. Regular blood pressure screening is important to detect high blood pressure early and prevent these long-term consequences through appropriate treatment.

FAQ’s

1: Is blood pressure hereditary?

Hypertension often runs in families, and having a parent with high blood pressure increases your risk of developing it as well. Thirty to fifty percent of the variation in blood pressure readings is thought to be due to genetic factors.

Rare, genetic forms of hypertension are caused by specific gene mutations that affect fluid and salt balance in the body, or the function of blood vessels. On the other hand, “essential” hypertension, which is more prevalent, is a complicated disorder that is influenced by a variety of environmental and genetic factors.

Genes involved in the renin-angiotensin-aldosterone system, which regulates blood pressure, as well as genes affecting the function of blood vessel linings, have been associated with increased hypertension risk. But no single gene is a common cause of essential hypertension.

In addition to genetics, shared environmental and lifestyle factors within families, such as diet, physical activity, obesity, and alcohol consumption, can also increase the risk of developing high blood pressure.

So in summary, hypertension does have a hereditary component, but it is a complex trait influenced by both genetic and environmental factors. Individuals with a family history of high blood pressure should be aware of their increased risk and take steps to manage modifiable risk factors.

2: How to check bp without machine?

You cannot accurately check your blood pressure without using a proper blood pressure cuff and monitor. Attempting to measure blood pressure by feeling the pulse in your wrist or fingers is not reliable and will not provide an accurate reading.

The most accurate way to measure blood pressure at home is to use an automated digital blood pressure monitor that wraps around your upper arm. These monitors are widely available and easy to use. They will display your systolic (top number) and diastolic (bottom number) blood pressure readings.

If you do not have access to a blood pressure monitor, the only option is to see a healthcare professional who can measure your blood pressure manually using a stethoscope and sphygmomanometer (blood pressure cuff). Trying to estimate your blood pressure by feeling your pulse is not recommended, as it can only provide a rough approximation of your systolic pressure, which may not be accurate.

The best approach is to purchase a validated home blood pressure monitor and track your readings over time. This will provide you and your doctor with the most reliable information to assess and manage your blood pressure effectively.

3: Does sugar raise blood pressure?

Studies show that sugar-sweetened beverages are linked to a 10% increase in blood pressure, also known as hypertension.  The added sugars in these drinks appear to have a direct negative impact on blood pressure.

However, sugars found naturally in whole foods like fruit, dairy, and whole grains do not have the same harmful effect on blood pressure. In fact, these healthier food sources with moderate amounts of sugar may even have a protective association with hypertension.

The key is the food source – sugar-sweetened beverages are problematic, but sugars that are part of a balanced, whole-food diet are not necessarily bad for blood pressure.  Reducing intake of added sugars, especially from sugary drinks, can help lower blood pressure.  But cutting back on salt intake is also important for managing hypertension.

In summary, while sugar can raise blood pressure, the effect depends on the type of food it comes from. Limiting added and refined sugars, especially from sugary drinks, is recommended, but a healthy, balanced diet with moderate amounts of natural sugars is not necessarily harmful for blood pressure.

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