children s health issues
High Blood Pressure in Children
Treatment of High Blood Pressure in Children
Weight loss, if needed Changes in diet Increased physical activity Sometimes drug treatment In children with high blood pressure, treatment may include increased physical activity, changes in diet to reduce salt and calorie consumption, weight loss, and sometimes drugs, depending on how severe the high blood pressure is. Usually, treatment of high blood pressure begins with changes in lifestyle that can help lower blood pressure, such as diet and, if needed, weight loss. The number of calories is limited based on activity level, age, and sex, and salt consumption is limited. TheDASH (Dietary Approaches to Stop Hypertension) dietcan be helpful. This diet emphasizes eating lots of fruits and vegetables and using low-fat dairy products. It includes poultry, fish, whole grains, and nuts and limits consumption of red meats, sweets, and salt. The diet is also low in saturated fat and cholesterol. Experts recommend For children who are 6 to 17 years old: 30 to 60 minutes of moderate to vigorous physical activity each day or at least 3 to 5 days a week For children under 6 years old: Physical activity throughout the day If blood pressure goals have not been reached after about 6 months of lifestyle changes, treatment with drugs also may be needed in some children. Children typically are referred to a specialist if their doctor requires help with prescribing drug therapy or if children have either of the following: Stage 1 hypertension especially with symptoms, organ damage, diabetes, or a kidney disorder Stage 2 (severe) hypertension Immediate drug treatment(plus lifestyle changes) is typically started if any of the following apply: High blood pressure, regardless of severity, causes symptoms. Stage 1 hypertension causes organ dysfunction or damage. Stage 2 hypertension is present. Children have chronic kidney disease, diabetes, or heart disease regardless of the stage of high blood pressure. Children who have milder forms of high blood pressure that are not controlled after about 6 months of lifestyle changes will need drug treatment. Drugs that are used in the treatment of high blood pressure are called antihypertensive drugs. Treatment is most effective when the parents, child, and doctor communicate well and discuss the drug treatment program, including possible side effects. Any antihypertensive drug can have side effects, so parents should be alert for them. If side effects develop, parents or the child should tell the doctor, who can adjust the dose or substitute another drug. Doctors typically start antihypertensive drugs, given by mouth, at a low dose and increase the dose as needed to lower blood pressure until the maximum dose of the drug is reached or side effects occur. If blood pressure is still too high, doctors may give children a second drug or switch drugs. There are many types of antihypertensive drugs. Categories include Adrenergic blockers None Angiotensin-converting enzyme (ACE) inhibitors None Angiotensin II receptor blockers (ARBs) None Calcium channel blockers None Thiazide diuretics None Vasodilators None The different types of antihypertensive drugs work in different ways, so there are many options for treatment. It is not unusual for someone who has high blood pressure to be prescribed more than one of these drugs. For a more detailed discussion of these types of drugs, see Drug Treatment of High Blood Pressure in Children . 