Early intervention is very important for children with hypertension
Formerly hypertension was a disease of adults, but recently it is appearing in children and adolescents. Two types of hypertension are distinguished: primary and secondary. It is essential to detect hypertension and start its treatment in children, to prevent further development of the disease in adulthood and the development of end-organ damage.
It is important to have the correct blood pressure readings to know the stage of hypertension
Admittedly, it is not so easy to detect hypertension in children. It is diagnosed using a special table, where age, gender, blood pressure readings, and blood pressure categories are placed. There are three categories: normal (50th -90th percentile), pre-hypertension (90th -95th percentile), stage I hypertension (95th -99th percentile), and stage II hypertension (more than 99th percentile). This table is very convenient since it is only necessary to find the corresponding age, find a child’s readings in systolic and diastolic blood pressure, and follow that raw to see the category percentile. It is very important to have the correct readings: blood pressure is to be measured after the child has been sitting no less than 5 minutes, using the right sized cuff.
Hypertension is often based on diseases
Hypertension is likely to occur in patients who have a relative with hypertension; patients with obesity problems; it may also be caused by renal diseases, heart diseases, rheumatologic diseases, endocrine diseases. In the latter case, additional testing is needed to detect the origin of hypertension. Early intervention is necessary since hypertension in children and adolescents can cause the development of the higher stage of hypertension in adulthood, numerous other diseases, one of which is end-organ damage.
The most effective treatment of hypertension is the modification of lifestyle
The most appropriate treatment of hypertension in children is lifestyle modification. First of all, it is necessary to take control of weight and start the diet if necessary. It is also vital to implement a reasonable amount of physical activity almost every day. This physical activity may last from 30 to 60 minutes per day. But it is important to keep balance in physical exercises. Finally, it can be helpful to keep to the corresponding diet to decrease blood pressure. It is necessary to increase the intake of fruits and vegetables, fiber, and non-fat dairy products. Consuming snacks and energy-dense beverages are essential. And it is also helpful to decrease the consumption of salt.
Hypertension in children is not commonly treated pharmacologically
As far as pharmacologic management is concerned it is necessary to point out that it is only used for patients with severe hypertension; with patients who show no results after lifestyle and dietary modifications, or for patients who, for some reason, cannot implement lifestyle and dietary modifications. This kind of treatment should be started with low doses of drugs, and then, if necessary, increasing portions. It is also should be mentioned that there are no guidelines in the pharmacologic treatment of hypertension in children; it should be based on specific characteristics of the patient. Diuretics and beta-blockers are commonly used for patients with hypertension but, some restrictions should also be made, since hypertension may be based on the diseases or damages of some organs in such cases, it is impossible to use drugs that can influence damaged organs or increase existing diseases.
It is necessary to educate children and parents on how to treat and prevent hypertension
In addition to the treatment mentioned above, it is necessary, first of all, to continue follow-up visits; and it is essential to educate children and parents that early detection and early intervention are very helpful. Moreover, it is necessary to promote a healthy way of life with healthy food and an active lifestyle.
Anglum, A. “Primary Care Management Of Childhood And Adolescent Hypertension.” Journal of the American Academy of Nurse Practitioners 21.10 (October 2009): 529-534.