Does my child have high blood pressure?

At each regular check-up, the doctor or nurse will check your child's blood pressure. They will compare your child's blood pressure to the blood pressure of other children of the same age, sex, and height. If your child's blood pressure is much higher than the blood pressure of other children, your doctor or nurse will check it again on 1 or more other days.

Children have high blood pressure if their blood pressure is much greater than that of other children on 3 or more different days. High blood pressure is also called "hypertension."

Some children have "elevated blood pressure." This is when blood pressure is somewhat higher than normal, but is not yet hypertension. This used to be called "prehypertension."

What are the symptoms of high blood pressure?

High blood pressure does not usually cause any symptoms.

Why does my child have high blood pressure?

High blood pressure can be caused by a medical condition. Other times, there is no known cause. High blood pressure can run in families.

Your doctor or nurse will want to figure out if a medical condition is causing your child's high blood pressure. They will talk with you and do an exam. During the exam, they will check the blood pressure in your child's arms and legs.

The doctor or nurse might also:

• Do blood and urine tests

• Do an ultrasound of your child's kidneys, or other imaging tests – These create pictures of the inside of the body.

• Monitor your child's blood pressure at home for a day – This is done with an "ambulatory blood pressure monitor." It has a cuff that goes on the arm and attaches to a recording device. If your child's doctor recommends this, they will give you a monitor and explain how your child should wear it. They will wear the monitor for 1 day and 1 night. During this time, the monitor automatically checks their blood pressure. They can do their usual activities during this time.

Why does high blood pressure need to be treated?

High blood pressure needs to be treated because it can lead to future problems:

• Children with high blood pressure can have high blood pressure as adults. Adults with high blood pressure have a greater chance of having a heart attack or stroke.

• A few children with very high blood pressure can have seizures or heart failure. Heart failure is when the heart cannot pump normally.

The goal of treatment is to lower your child's high blood pressure until it is at a normal level.

How is high blood pressure treated?

First, doctors treat any medical conditions that might be causing the high blood pressure.

But treating the cause does not always reduce high blood pressure. Or there might not be a known cause. In these cases, high blood pressure is treated with:

• Lifestyle changes

• Medicines

Which lifestyle changes might be part of treatment?

Lifestyle changes that might be part of treatment include:

• Losing weight, if your child has excess body weight – Your doctor or nurse might recommend you work with a "nutritionist." This is an expert on food and eating.

• Diet changes – These might include eating healthier foods or reducing salt in your child's food. Healthy foods include fruits, vegetables, and low-fat dairy foods.

• Getting regular exercise – Most children should get "aerobic" exercise for 20 to 30 minutes a day, most days of the week. Aerobic exercise includes activities such as walking, running, swimming, or biking. The doctor or nurse will tell you if there are activities your child should avoid.

• Being active – This means not spending a lot of time sitting, watching TV, or playing computer games.

• Not smoking or drinking alcohol – Doctors also recommend family members not smoke. Children who breathe in smoke can get heart problems.

Which medicines might be part of treatment?

Doctors can use different types of medicines to treat high blood pressure. They work in different ways and can have different side effects. Your doctor will work with you to find the right medicine for your child.

What else should I know?

The doctor or nurse will follow up with you and your child regularly. On each visit, they will check your child's blood pressure. Tell them if your child has any problems with treatment.