Pediatric Systemic Hypertension: Causes, Diagnosis & Treatment

Pediatric systemic hypertension refers to abnormal blood pressure elevation in children and adolescents. It may be primary (with no known cause) or secondary to an underlying disease, with negative effects on overall health.

Diagnosis &Definition

• The diagnosis of pediatric systemic hypertension depends on gender, age and height percentiles, and requires repeated measurements and tests. According to the Nelson Textbook of Pediatrics, the threshold is a blood pressure (BP) that is consistently above the 95th percentile for age. Average BP values between the 90th and 95th percentiles define pre-hypertension.

Hypertension in Infants and Newborns

• The Family Practice Notebook considers systemic hypertension significant when it consistently exceed the following values: 112/74 mm Hg (for children younger than 2 years); 104 mm Hg systolic BP (for ages 8 days to 30 days); and 96 mm Hg systolic BP (for infants younger than 7 days).

Hypertension in Adolescents &Children

• The Family Practice Notebook considers systemic hypertension significant when it consistently exceeds the following values: 142/92 mm Hg (for ages 16 to 18); 136/86 mm Hg (for ages 13 to 15); 126/82 mm Hg (for ages 10 to 12); 122/78 mm Hg (for ages 6 to 9); and 116/76 mm Hg (for ages 3 to 5).

Risk Factors

• Nelson Textbook of Pediatrics reports several risk factors, including: obesity, physical inactivity, high blood cholesterol, high dietary sodium intake, heredity, endocrine disorders, and alcohol and tobacco use.

Signs &Symptoms

• Pediatric systemic hypertension may or may not produce symptoms. Possible manifestations listed in Nelson Textbook of Pediatrics include: headaches, dizziness, nose bleeding, anorexia, vision disturbances, seizures, as well as heart and kidney malfunction.

Treatment

• Nonmedical treatment options include: dietary salt restriction, weight loss, and exercise. Some children and adolescents may require hypertensive drugs for emergency situations and/or ongoing therapy.