Hypertension (High Blood Pressure)
We never had to worry about kiddos with high blood pressure. Unfortunately today, the same risk factors for adult hypertension are the same for kids; obesity, sedentary lifestyle, poor nutrition and genetic susceptibility.
What is Pediatric Hypertension
According the the Mayo Clinic:
- Hypertension is defined as average systolic blood pressure (SBP) and/or diastolic blood pressure (DBP) that is greater than or equal to the 95th percentile for sex, age, and height on three or more occasions.
- Prehypertension in children is defined as average SBP or DBP levels that are greater than or equal to the 90th percentile, but less than the 95th percentile.
- As with adults, adolescents with BP levels greater than or equal to 120/80 mmHg should be considered prehypertensive.
- A patient with BP levels above the 95th percentile in a physician’s office or clinic, who is normotensive outside a clinical setting, has white-coat hypertension. Ambulatory BP monitoring (ABPM) is usually required to make this diagnosis.
Conventional Medical Treatment
National Institutes of Health (NIH)-
Commonly Prescribed Medications
(please see NIH paper above for common dosages/age):
Angiotensin-converting enzyme (ACE) inhibitor
- Benazepril
- Captopril
- Enalapril
- Fosinopril
- Lisinopril
- Quinapril
Angiotensin-receptor blocker
- Irbesartan
- Losartan
Alpha and Beta- blocker
- Labetalol
Beta- blocker
- Atenolol
- Bisoprolo/HCTZ
- Metoprolol
- Propanolol
Calcium channel blocker
- Amlodipine
- Felodipine
- Isradipine
- Extended-release nifedipine
Central Alpha-agonist
- Clonidine
Diuretic
- HCTZ
- Chlorthalidone
- Furosemide
- Spironolactone
- Triamterene
- Amiloride
Peripheral Alpha-agonist
- Doxazosin
- Prazosin
- Terazosin
Vasodilator
- Hydralazine
- Minoxidil
Naturopathic Medical Treatment Options
(may be used in conjunction with conventional options and/or used alone)
Diet
- fruits and vegetables (dirty dozen/clean 15), whole grains, lean proteins, healthy fats
- remove excess salt, sugar and unhealthy fats from the diet
- fiber – psyllium husk, oats
Exercise (for weight related hypertension)
- PLAY, PLAY, PLAY
- engage in sport activities
- exercise should be FUN, please get creative for your child
- 30-60 minutes per day
Vitamins and Supplements
- Fish Oil- EPA + DHA = 1-2 grams per day with food
- Magnesium 200-400 mg daily
Other Options
- Arginine 1-2 grams daily (do NOT give if child is taking an ACE inhibitor)
- Sleep- 9-12 hours sleep per night (age dependent)
Resources
- www.nih.gov
- The effect of a fibre supplement compared to a healthy diet on body composition, lipids, glucose, insulin and other metabolic syndrome risk factors in overweight and obese individuals. British Journal of Nutrition 2011; 105(1):90–100.
- Giacosa A, Rondanelli M. The right fiber for the right disease: An update on the psyllium seed husk and the metabolic syndrome. Journal of Clinical Gastroenterology 2010; 44 Suppl KS58–S60.
- Mori TA, Bao DQ, Burke V, et al. Docosahexaenoic acid but not eicosapentaenoic acid lowers ambulatory blood pressure and heart rate in humans. Hypertension 1999; 34(2):253–260.
- Nelin LD, Hoffman GM. L-arginine infusion lowers blood pressure in children. Journal of Pediatrics 2001; 139(5):747–749.
- Skowron, Jared M. (2011-08-02). 100 Natural Remedies for Your Child: The Complete Guide to Safe, Effective Treatments for Childhood’s Most Common Ailments, from Allergies to Weight Loss. Rodale.
- Williams CL, Hayman LL, Daniels SR, Robinson TN, Steinberger J, Paridon S, et al. Cardiovascular health in childhood: A state- ment for health professionals from the Committee on Atherosclerosis, Hypertension, and Obesity in the Young (AHOY) of the Council on Cardiovascular Disease in the Young, American Heart Association. Circulation 2002;106:143–60.
- Whelton SP, Chin A, Xin X, He J. Effect of aerobic exercise on blood pressure: A meta- analysis of randomized, controlled trials. Ann Intern Med 2002;136:493–503.
- Robinson TN. Behavioural treatment of childhood and adolescent obesity. Int J Obes Relat Metab Disord, 1999;23 Suppl 2:S52–S57.
- Barlow SE, Dietz WH. Obesity evaluation and treatment: Expert Committee recom- mendations. The Maternal and Child Health Bureau, Health Resources and Services Administration and the Department of Health and Human Services. Pediatrics 1998;102:e29. Available at: www.pediatrics.org/cgi/content/full/102/3/e29. Verified July 12, 2004.
- Krebs NF, Jacobson MS. Prevention of pedi- atric overweight and obesity. Pediatrics 2003;112:424–30.
- U.S. Department of Health and Human Services. The Surgeon General’s call to action to prevent and decrease overweight and obesity. Rockville, MD: U.S. Department of Health and Human Services, Public Health Service, Office of the Surgeon General. 2001.
- Gutin B, Owens S. Role of exercise intervention in improving body fat distribution and risk profile in children. Am J Human Biol, 1999;11:237–47.
- Siega-Riz AM, Popkin BM, Carson T. Trends in breakfast consumption for children in the United States from 1965–1991. Am J Clin Nutr 1998;67:748S–756S.
- Warren JM, Henry CJ, Simonite V. Low glycemic index breakfasts and reduced food intake in preadolescent children. Pediatrics 2003;112:e414. Available at: www.pediatrics.org/cgi/content/full/112/ 5/e414. Verified July 12, 2004.
Reviewed/Updated: 09/14
Content Created: 05/14
