Risk factors for high blood pressure in children

Childhood hypertension similar to adults will include 2 main causes: primary and secondary hypertension:
Secondary childhood hypertension is often the result of other diseases such as parenchymal abnormalities or renal vessels, coarctation of the aorta; Primary childhood hypertension is related to factors such as family genetics, obesity status, nutrition (such as eating a lot of calories, using fast food, high fat or drinking carbonated water.. .), physical activity mode, stress... Especially, children who are obese, have growth retardation or have other problems such as recurrent urinary tract infections, blood in the urine, individual or family Children with congenital kidney disease have a very high risk of developing high blood pressure. Therefore, these schools need regular blood pressure monitoring, thereby detecting high blood pressure in children and taking appropriate interventions. Statistically, the prevalence of childhood hypertension is very low (less than 1%) and often elevated blood pressure suggests another underlying medical condition (secondary hypertension).
Most cases of high blood pressure in children with severe or symptomatic severity are secondary hypertension. Meanwhile, the number of cases of primary hypertension in children is mostly in school age or adolescents and often increases with the prevalence of obesity.
Some cases in which a child needs a blood pressure monitoring plan include:
History of premature birth, very low birth weight or complications at the neonatal age requiring intensive resuscitation treatment; Congenital heart disease ; Kidney disease or urinary tract malformation; Children who received solid organ transplants (such as liver, kidney...); Malignant diseases; Children receiving bone marrow transplants; Children using drugs that can cause high blood pressure; Systemic diseases associated with hypertension (eg, multiple sclerosis); Children have increased intracranial pressure.

In 2017, the American Academy of Pediatrics issued guidelines for pediatricians on the diagnosis of childhood hypertension. Unlike measuring blood pressure in adults, the Association does not provide a specific level of normal blood pressure readings when using blood pressure devices (both systolic and diastolic). Blood pressure readings that are considered normal will depend on other factors for the child, such as age, sex, and height.
Along with that, the American Heart Association once recommended that all children 3 years of age and older should have their blood pressure checked every year. If the child's blood pressure is determined to be high, the doctor will ask the parents to take the child for a few more follow-up visits. In addition, doctors can assign these cases to use a mobile device to measure blood pressure continuously for 24 hours. If the blood pressure readings are abnormal, the child is diagnosed with childhood hypertension.
To facilitate the process of diagnosis and treatment, the doctor needs some other information to determine the cause of the disease, especially the health history including factors such as nutrition, level of physical activity, activities usually done at home, at school and some factors that can cause stress for the baby... Besides, the child will be assigned a number of tests such as urine, blood and renal ultrasound ... From there, it is possible to diagnose primary or secondary hypertension in children.
High blood pressure in children in the early stages often does not show any symptoms. In rare cases, symptoms such as headache, dizziness, nausea, vomiting, flushing of the face, nervousness, palpitations, sweating or even convulsions, decreased vision, edema...
Similar to adults, childhood hypertension is considered a "silent killer" because of atypical symptoms and dangerous complications that often appear suddenly and endanger health.
Chronic cases of high blood pressure in children, not diagnosed and treated early, can cause many serious complications. Cardiovascular complications associated with this disease include: myocardial hypertrophy (commonly left ventricular hypertrophy), heart failure, vascular damage, retinal damage or neurological complications. High blood pressure in children can leave a number of consequences as the child grows up, such as an increased risk of diseases such as stroke, coronary heart disease, heart failure, and kidney failure.

The first requirement when measuring blood pressure in children is that the blood pressure monitor must have the size of the balloon (used to wrap around the arm) suitable for the child's hand, not too big, nor too small.
Before measuring blood pressure, the child must rest comfortably for about 10 to 15 minutes. The space where the blood pressure is measured must be comfortable, the child must lie still and not cry (for young children).
Under normal conditions, children need to have blood pressure measured in both arms to ensure accuracy because children with coarctation of the aorta will have lower blood pressure in the left arm than the other.
The child's blood pressure value will then be compared with the table of normal blood pressure values ​​according to age, sex, and height. From there determine whether there is high blood pressure in children or not.

Childhood hypertension is completely preventable, and supports effective treatment if children are guided to change their lifestyle and apply a scientific diet. According to the recommendations of heart experts, parents of young children with hypertension should pay attention to the following issues:
Maintain a suitable child's body weight, avoid obesity and overweight; Ensure a balanced diet of all groups of substances in a reasonable and scientific manner, minimizing foods containing a lot of sugar, salt, fat, and fast food. Note that the amount of added salt per day for children aged 4-8 years is 1.2 grams, for older children it is 1.5 grams. At the same time, the diet should be enhanced with foods rich in fiber, supplemented with green vegetables, fresh fruits...; Create appropriate physical activity habits for children such as daily exercise routine, encourage children to participate in outdoor fun activities. At the same time, it is necessary to limit children sitting too long in front of the screen, playing games, watching TV...; There are measures to help children cope with stress: Stress, mental stress is the cause of high blood pressure in children and adults.

In the diet of children with high blood pressure, it is also necessary to pay attention:
The diet should use more fish processed dishes than meats, when feeding children meat, it is necessary to remove the fatty skin. Should add to the meal tofu and other legumes to replace meat; Fortified with milk to provide more calcium and other nutrients; Limit supplements for children with high blood pressure with foods that contain a lot of salt or sugar, and limit fried or fried foods because of their high fat content; Replace animal fats with vegetable oils; Limit foods high in cholesterol and saturated fatty acids such as animal fat (except fish fat), skin, viscera, and egg yolk. There are many causes of high blood pressure in children, so parents need to pay attention and pay attention to their children's signs so that they can take the child to a doctor and get treatment when necessary.
With many years of experience in examining and treating diseases in children, now the Pediatrics Department at Vinmec International General Hospital has become one of the major health care centers, capable of examining , screening and treatment of many specialized diseases in children. Therefore, if the child shows signs of hypertension, parents can take the child to Vinmec International General Hospital for examination and receive support and advice from doctors and nutritionists. .