Easing the tension
Wednesday, September 01, 2004
Doctors are being urged to check children for high blood pressure :::::::::::::::::::::::::::::::::Chicago Parent file photo Even babies can have high blood pressure, doctors now say.
Hypertension is thought of as an adult disease, yet high blood pressure can start in infancy and should be treated as early as age 3, according to a study recently published by the American Academy of Pediatrics' journal Pediatrics. It's a new idea for parents and for some pediatricians as well.
The academy now recommends children's blood pressure be checked during every health care visit starting at age 3. For children under 3, blood pressure readings are recommended only for certain at-risk groups, such as premature infants, says Dr. Joseph Flynn, director of the Pediatric Hypertension Program at Children's Hospital at Montefiore in New York City, who served on a national education working group studying the issue.
Left untreated in children, high blood pressure can lead to life-threatening organ damage.
Flynn says the need for testing children stems from the current epidemic of childhood obesity, a primary factor in high blood pressure. But, he says, in many cases the hypertension may also be caused by an underlying medical problem.
Normal blood pressure in infants is 80/45, but in some cases of hypertension, it has been measured at 116/70, a rate normal for teenagers.
While doctors do prescribe high blood pressure medication to children, Flynn says the first step toward helping children become healthier is to make a change in the child's lifestyle.
If those changes don't work or the child is in danger of long-term organ damage, Flynn recommends high blood pressure medication.
But medicating children is controversial because there are no medications developed specifically for children with hypertension. The drugs currently used have been tested only on adults. However, Flynn suggests, in extreme cases it is worth the risk to prevent further damage to young children's organs.
"Pediatricians are more and more aware of blood pressure as a problem. We are measuring it more often in routine care, as are physicians in emergency rooms when kids come in for other issues. I think there is still some work to be done in terms of having testing happen uniformly across all pediatric process on a regular basis," says Dr. Stephen Daniels, another member of the working group who is on staff at Cincinnati Children's Hospital Medical Center and is also a professor at the University of Cincinnati College of Medicine.
"If people pay attention to these guidelines, they should be doing these things," Flynn says, "but if the child isn't having it done already, or if there's a family history of high blood pressure or the child is exhibiting signs of hypertension, absolutely [parents] should ask their pediatrician about testing for high blood pressure."
For more information, visit www.aap.org. Russell Jaffe