Why is your increased blood pressure in fact a problem

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In rare cases, severe hypertension can cause headaches , visual changes, dizziness, nosebleeds , heart palpitations, and nausea. If your child has severe high blood pressure and has any of these symptoms, get medical care right away.

When the heart contracts and pushes blood into the vessels, blood pressure rises. It lowers when the heart relaxes, but there's always some pressure in the arteries. Blood pressure changes from minute to minute and is affected by activity and rest, body temperature, diet, emotional state, posture, and medicines. Health care providers measure blood pressure with a sphygmomanometer sfig-mo-muh-NAH-muh-ter , which has a cuff that's wrapped around the upper arm and pumped up to create pressure. When the cuff is inflated, it squeezes a large artery in the arm, stopping the blood flow for a moment.

Blood pressure is measured as air is gradually let out of the cuff, which allows blood to flow through the artery again. The doctor or nurse will also put a stethoscope over an artery to hear the first pulse as the blood flows through — this is the systolic pressure or the pressure at the peak of each heartbeat. The diastolic pressure the pressure when the heart is resting between beats is noted when the sounds disappear. When a blood pressure reading is taken, the higher number represents the systolic pressure and the lower number represents the diastolic pressure.

6 Facts About High Blood Pressure

As kids grow, their blood pressure increases from a systolic pressure of about 70—90 as babies to adult values when they're teens. Automated devices, which are good for screening, also can measure blood pressure, but a manual blood pressure measurement is more accurate. All kids should have their blood pressure checked regularly. Doctors usually start measuring blood pressure during routine checkups when kids are 3 years old.

So it's important not to miss these appointments, particularly if your child is overweight or there's a family history of high blood pressure.

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Blood pressure varies a lot from day to day, so several blood pressure checks might be done to make a diagnosis unless the pressure is very high, and then treatment is needed right away. It's not unusual for a first blood pressure reading to be high if a child is nervous, so the health care provider will likely take three readings, then use an average of the three to determine whether a child has or is at risk for high blood pressure.

Some doctors use a test called ambulatory blood pressure monitoring in which a child wears a blood pressure cuff all day to confirm a hypertension diagnosis. It's often more accurate than blood pressure tests in the doctor's office because the child is less likely to be affected by any stress from the office visit.

How to keep your numbers at healthy levels

If an illness is causing hypertension, treating it might be enough to get the blood pressure back to normal. Many kids and teens with high blood pressure have an unhealthy lifestyle — a bad diet, excess weight, stress , and too little physical activity. So the health care provider might recommend weight loss, exercise, reduced screen time time spent watching TV, or using a computer or mobile devices , dietary changes, and even relaxation techniques. The AAP and the National Heart, Lung and Blood Institute both recommend that children have yearly screenings for high blood pressure, starting at age 3, at their annual well-child visits.

If your child's blood pressure is high , he or she will typically be asked to come back a week later to see if the high readings persist. If your child has elevated readings in three consecutive visits , he or she should have an evaluation for the cause of hypertension and risk of organ injury. Infants who were preterm, or of low birth weight, who had a difficult or long hospital stay may need blood pressure screenings sooner than age 3.

Tip for parents: Remember to ask your pediatrician if he or she measured your child's blood pressure, and if so, if it was a concerning reading. In many cases, high blood pressure seems to develop with age. As a result, a child may show no signs of high blood pressure as an infant, but may develop the condition as he or she grows. These tests include studies of the urine and blood.

In most children and adolescents, no specific cause is found for hypertension. This will need to be very closely monitored by your pediatrician. Not only will weight loss lower blood pressure, it can provide many other health benefits as well.

Screening & Treating Kids for High Blood Pressure: AAP Report Explained

Limit the salt in your child's diet. Giving up the use of table salt and restricting salty foods can lower blood pressure in some patients. Common sources of salty foods include bread, deli meats, pizza, and foods prepared outside the home.

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Use caution when shopping for packaged foods. Help your child get more aerobic exercise. The AAP recommends 60 minutes of physical activity each day.

AHA recommendation

The AAP guidelines recommend pediatricians start blood pressure-lowering medications if lifestyle changes fail to reduce your child's blood pressure, or your child has another condition like diabetes or kidney disease. There are a variety of anti-hypertensive medications that have been tested and proven to be safe in the short- and long-term.

Once your pediatrician knows your child has high blood pressure, he or she will want to check it frequently to make sure the hypertension is not becoming more severe.

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High Blood Pressure and Kidney Disease in Children | National Kidney Foundation

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