Hypertension in Children


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Recent reports have shown that the number of children and adolescents affected by hypertension appears to have soared. While some have genetically gained hypertension, it is still mainly due to their excessive eating habit of not-so-healthy food that led to an epidemic of childhood obesity. Early childhood hypertension may lead to an early development of coronary artery disease (CAD) when they get older. Left ventricular hypertrophy (LVH) is the most fatal evidence of childhood hypertension’s end-organ damage. It was reported that 41% of patients of childhood hypertension develops left ventricular hypertrophy and they are also at an increased probability to develop congestive heart failure, seizures, hypertensive encephalopathy, cerebrovascular accidents. So looking at the fatal results, it is essential for the disease be detected and treated at the early stages of their life, before it becomes long-term complications.

The US study has examined 3,500 US children from the age of 8 to 17 in 1988-1994, and had their blood pressure compared to 2,086 US children of the same age in 1999-2000. The average of systolic blood pressure was 104.6 mmHg in 1988-1994, and has increased to 106 mmHg in 1999-2000. The average of diastolic blood pressure for children in 1988-1994 was 58.4 mmHg, and this number rose to 61.7 mmHg in the year of 2000. Result shows that the children’s systolic blood pressure has gone up by an average of 1.4 mmHg, while their diastolic blood pressure to a whopping 3.3 mmHg by 2000. Researches suggested that even for 1-2 mmHg increase in systolic blood pressure, a child boosted his/her risk of developing high blood pressure by a whopping 10%. As a result, children that were examined in 2000 have a 14% higher risk of high blood pressure when they get older compared to children that were examined in 1988-1994.

Childhood hypertension, especially with younger children, is greatly involved with the relationship of blood pressure and body mass index (BMI) as compared to adults, which again, goes to indicate that obesity plays the major role in the development of childhood hypertension, while chances of children hypertension heritability is at 50%. Children who are bigger and taller tend to have higher blood pressure than smaller ones, and they are more likely to develop hypertension when they grow up as adults. The role of children hypertension in ethnicity is still questionable, but statistics show that black children possess higher blood pressure than any other race.

Childhood hypertensions are mostly secondary, which differs to that of adolescents who generally have essential hypertension. The number of children under 10 years of age who have essential/primary hypertension is considered to be very rare. Although rare, young children who do have essential hypertension, usually have a family history of hypertension or cardiovascular disease.

The possible causes of childhood hypertension are divided into a few age groups:

  • 1 to 6 years – Renal parenchymal disease, renal vascular disease, coarctation of the aorta, essential hypertension
  • 6-12 years – Renal parenchymal disease, essential hypertension, renal vascular disease, endocrine causes, iatrogenic illness, coarctation of the aorta
  • 12-18 years – Essential hypertension, renal vascular disease, renal parenchymal disease, iatrogenic illness, endocrine causes, coarctation of the aorta

Understanding hypertension in children may very well change the future of our children for the better.