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What you need to know for 09/26/2017

Hypertension a growing threat among young children, teenagers

Hypertension a growing threat among young children, teenagers

While high blood pressure is commonly thought of as an adult health issue, teenagers and even younge
Hypertension a growing threat among young children, teenagers
Dr. Tyrone Bristol, associate professor of pediatrics and attending pediatrician at Albany Medical Center, takes a blood pressure reading on 7-year-old Saif Ullah of Albany.
Photographer: Marc Schultz

While high blood pressure is commonly thought of as an adult health issue, teenagers and even younger children can also develop the problem.

“It’s one of the issues that we screen for,” said Dr. Tyrone Bristol, associate professor of pediatrics and attending pediatrician at Albany Medical Center. “We routinely start blood pressure screening at around age 3. If there are any worries, we start before that.”

Teenagers in the United States now weigh more and exercise less than teens of past generations. As a result, high blood pressure among teens has increased as well.

A large study showed that high blood pressure in teenagers increased from 1 percent to 5 percent between 1989 and 2002.

Chronic high blood pressure can affect the heart and can cause the pumping chamber (the left ventricle) to become enlarged. Therefore, developing high blood pressure at an early age can lead to cardiovascular problems later in life.

Extra work

“Putting that extra work on the heart changes how the heart functions in terms of how blood gets from your heart to the rest of the body,” said Bristol.

So instead of being active like average teenagers, these teenagers may suffer from chest pain, breathlessness and exercise intolerance, especially if the hypertension goes undiagnosed or is not treated or well managed.

“Even when they are on medication, they can have some symptoms. So obviously, the goal is to prevent high blood pressure, or if you can’t prevent it, then diagnose it early and treat it appropriately,” said Bristol.

When a child or teenager has high blood pressure, it’s also important to make sure there is no secondary cause like kidney problems, thyroid problems or polycystic kidneys.

“The thinking in pediatrics is you should check and make sure there is no other reason for high blood pressure other than family-associated high blood pressure or obesity, because you could miss other issues that could be fixed,” he said.

If no other disease is present and an overweight teen complains of chest pain, the teen is usually referred to a cardiologist, who gives him an electrocardiogram (EKG) and an echocardiogram or ultrasound of the heart.

“Some kids will also have headache, fatigue and lethargy,” said Bristol. “So when a child or teenager comes in to see us, we do a full set of vital signs like their height and weight, pulse and blood pressure rate,” said Bristol.

Bristol recommended that children and teenagers have their blood pressure tested annually at every physical, and before they participate in sports.

“If they are obese and have an acute headache, chest pain, fatigue or weakness, it should be done more often,” he said.

Once high blood pressure is diagnosed and the cause is found, teenagers should be referred to the proper specialist. If obesity is the cause, teens are often referred to a cardiologist.

“In terms of diet and nutrition, the pediatrician or family doctor becomes important in terms of helping to design a healthy diet and encouraging weight loss,” said Bristol.

Proper exercise

Depending on how severe the high blood pressure is, exercise is also important.

“The problem is when you exercise, your blood pressure goes up. So you may need a consultation with a cardiologist to help get a sense of which kind of exercise is safe,” said Bristol.

Studies show that meditation — 15 minutes twice a day — may also be helpful for teens with high blood pressure.

“Meditation, biofeedback, yoga — all of those things have been around for years in terms of teaching folks how to control stress,” said Bristol. “And teenagers have very stressful lives. If they have high blood pressure on top of that, I think adding any of those as a way to relieve stress and tension is a very good idea as long as they have gotten appropriate medical treatment.”

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