Blood Pressure New Guidelines – What This Means for Your Child and You

THE PRESSURE IS ON

Hylton I Lightman, MD, DCH (SA), FAAP

This week’s news announced by the American Heart Association and the American Cardiology Association has eclipsed almost everything in the world, especially the world of medicine.

The News:

Any adult with blood pressure (BP) higher than 130/80 will be considered to have hypertension, or high blood pressure.

The 130/80 benchmark has been lowered from the previously established guidelines accepted worldwide of 140/90.

What does this mean for our children?

Let’s define children as up to 18 years of age.

Traditionally, the American Academy of Pediatrics (AAP) has associated overweight and obesity with elevated BP and hypertension (HTN) in children. Recently, the AAP has created new normative BP tables based on normal-weight children. As a result, the numbers which define elevated blood pressure have been lowered.

What does this mean practically for your child and his/her health care?

Your child’s BP should be measured annually at the well visit starting at 3 years of age.

When your child’s BP is measured, your pediatrician’s staff should make sure to use appropriately size cuffs to ensure an accurate measurement.

Your child, who may be at greater risk of hypertension and should have his BP measured at every office visit if he/she is:

obese
takes medications known to increase BP – such as stimulants which treat ADHD
has renal disease
history of aortic arch obstruction or coarctation
diabetes

If your child falls under ANY of the above mentioned, he/she should have BP measured at ALL sick visits as well as annual well visits.

Please inform your pediatrician if there is a family history of heart disease or hypertension.

It is important to take more than one BP measurement over time.

One elevated BP reading does not constitute hypertension; sometimes, it can be White Coat Syndrome (fear of physician). My colleague pediatric cardiologist Dr. Eliyahu Rosman of Northwell Health System says that if a child or adolescent has confirmed BP readings at or above the 95^th percentile on three different visits, this justifies a diagnosis of HTN. Your pediatrician would then refer your child to a pediatric cardiologist or sometimes, a nephrologist.

In the meantime, all children, adolescents, and adults should strive to pursue and live healthy lifestyles which include a healthy food plan and physical activity. The benefits are manifold.