By Sue Hubbard, M.D., www.kidsdr.com
When you take your child in for a check-up, does your pediatrician check the youngster’s blood pressure? The American Academy of Pediatrics (AAP) recommends that children, beginning at the age of 3, should routinely have their blood pressure checked.
In certain circumstances, even younger children should have their blood pressure checked. With the growing epidemic in obesity, pediatricians are seeing more children with abnormal blood pressure readings.
It’s important that the right sized blood pressure cuff be used for measuring a child’s blood pressure. There are standards for blood pressures children of different ages. The standards are also based on a child’s height.
When a child’s blood pressure reading is greater than the 90th percentile for their age, they’re said to have pre-hypertension. The prevalence of childhood hypertension is thought to be between one and four percent, and may even be as high as 10 percent in obese children.
Obesity plays a role, but related to that is inactivity among children, diet, and their genetic predisposition for developing high blood pressure. It is appropriate for further work up to be done to evaluate the reason for the elevated blood pressure.
If I have a patient with a high blood pressure reading during their physical exam, it’s important to re-take their blood pressure in both arms. I also don’t depend on automated blood pressure readings, as I find they are often inaccurate. I prefer to use the “old-fashioned” cuff and stethoscope to listen for blood pressure.
If a blood pressure reading is abnormal, I have the child/adolescent have their blood pressure taken over a week or two at different times of day. They can have the school nurse take it and parents can also buy an inexpensive blood pressure machine to take it at home. I then look at all the readings to confirm that they are consistently high.
The “white coat” syndrome, when a doctor assumes that the elevated blood pressure is due to anxiety, may not actually be the case, so make sure that repeat blood pressures are taken. If your child does have elevated blood pressure readings, it’s important that further evaluation be done, either by your pediatrician or by referral to a pediatric cardiologist.
(Dr. Sue Hubbard is an award-winning pediatrician, medical editor and media host. “The Kid’s Doctor” TV feature can be seen on more than 90 stations across the U.S. Submit questions at http://www.kidsdr.com. The Kid’s Doctor e-book, “Tattoos to Texting: Parenting Today’s Teen,” is now available from Amazon and other e-book vendors.)