High blood pressure (hypertension) is usually thought of as a problem in older adults; however, there are conditions that can cause high blood pressure in children and young adults as well. High blood pressure is often called the “silent killer” because it does not have symptoms but causes damage to the body, including the eyes, heart, brain, and kidneys. Screening for high blood pressure is recommended starting at 18 years old. Pediatric guidelines recommend screening starting at 3 years old.
In children, we screen for high blood pressure in several ways:
- It is checked as a vital sign at routine well visits every year starting at 3 years old.
- A risk assessment is done in children less than 3 years old, and it is checked in those at higher risk.
- It is checked routinely in children who have obesity, kidney disease, diabetes, aorta malformations, or are taking medications which increase blood pressure.
Ricks in children for high blood pressure include:
- History of premature birth < 32 weeks, very low birth weight, or some birth complications requiring stay in the neonatal intensive care unit (NICU)
- Congenital heart disease
- Recurrent urinary tract infections
- Kidney disease or urological malformations
- Family history of congenital kidney disease
- History of solid organ transplant
- Cancer or bone marrow transplant
- Drugs which cause elevated blood pressure
- Certain conditions including neurofibromatosis and tuberous sclerosis
- Evidence of increased intracranial pressure
References
Flynn JT, Kaelber DC, Baker-Smith CM, et al. Clinical Practice Guideline for Screening and Management of High Blood Pressure in Children and Adolescents. Pediatrics. 2017;140(3). doi:10.1542/peds.2017-1904