Tuesday, 12 May 2015

Hypertension in children: Never ignore high blood pressure in children younger than 10 years

Hypertension in children: Never ignore high blood pressure in children younger than 10 years

17th May is World Hypertension Day

Hypertension or high blood pressure is a condition that is usually prevalent in adults. However, hypertension is now becoming common in children too.

Speaking on the occasion of World Hypertension Day, Padma Shri Awardee Dr A Marthanda Pillai National President Indian Medical Association (IMA) and Padma Shri Awardee Dr KK Aggarwal Honorary Secretary General IMA and President Heart Care Foundation of India said that hypertension in childhood and adolescence contributes to the early development of heart disease, but all high BP in children is not benign. Curable blood pressure in children should always be ruled out, especially in children when they develop blood pressure below the age of 10.

World Hypertension Day is celebrated on 17th of May every year in order to create awareness about hypertension amongst the public around the world. The theme for 2015 is ‘Know your Numbers’.

IMA released some facts on high BP in children on the occasion.

·         First blood pressure should be checked at age of 4 years.

·         Hypertension in childhood and adolescence contributes to premature heart disease.

·         Childhood hypertension is divided into two categories: primary hypertension (no identifiable cause is found) and secondary hypertension (an underlying cause is identified).

·         Always identify a child with secondary hypertension, who may have a curable disease.

·         Always identify other comorbid risk factors like obesity, abnormal lipids, diabetes.

·         It has become clear that hypertension begins in childhood and adolescence, and that it contributes to the early development of heart disease. 

·         Secondary hypertension should be suspected in children with one or more of the following findings:

o  Pre-pubertal, particularly younger than 10 years of age.

o  A thin child with a negative family history for high BP

o  An acute rise in blood pressure above a previously stable baseline.

o  Severe HT defined as stage 2 HT (BP >5 mmHg above the 99th percentile)

o  Past history of urinary tract infection, especially pyelonephritis, or underlying congenital kidney or urologic anomalies raises the possibility of renal scarring.

o  Symptoms suggestive of excess levels of catecholamines include headache, sweating, and tachycardia in addition to high BP

o  Ambiguous genitalia

o  Swelling feet

o  Blood in urine

o  Family history of chronic or congenital kidney disease (such as polycystic kidney disease)

o  Drugs history (steroids, or oral contraceptives)

o  History of umbilical arterial catheterization as a neonate.

o  Presence of an abdominal bruit

o  High BP in upper limbs and low BP in lower limbs. 

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