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    Check Blood Pressure Starting at Age 3

    <P>Children With High Blood Pressure Should Be Treated</P>

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    Children with blood pressure readings that put them in 95th or higher percentile have hypertension. For these children, lifestyle changes should be initiated, but Falkner says that it is unlikely that exercise and diet will be enough to control blood pressure in these kids. When six months of diet and exercise don't control blood pressure, the guidelines recommend that children be given high blood pressure medications used in adults to treat the condition.

    She says most of these drugs -- beta blockers, calcium channel blockers, angiotensin-converting enzyme (ACE) inhibitors, and angiotensin receptor blockers (ARBs) have been tested in children. But diuretics, which are among the oldest and cheapest high blood pressure drugs, have not yet been tested in children.

    Falkner says that children who "are competitive athletes and children with asthma are probably not good candidates for beta blockers, which slow the heart rate." She says that ACE inhibitors and ARBs, which are the drugs commonly used to treat adults with diabetes and high blood pressure, are a good choice for children with diabetes and high blood pressure.

    Children should be evaluated for damage to organs such as the heart and kidneys, Falkner says. This, too, marks a change in the guidelines and is yet another indication of the growing concern about high blood pressure in kids.

    A Wake-Up Call for Society

    American Heart Association spokesman Daniel Jones, MD, tells WebMD that the new guidelines should be a wake-up call to the nation about the need to get serious about high blood pressure in children. While it is estimated that 1% to 3% of children and adolescents may have hypertension, Jones says this is a major problem. "While 3% may not seem like a lot, we know that high blood pressure tracks with age," he says. These children with high blood pressure are likely to grow into a generation of young adults who have heart attacks, strokes, and kidney failure at a young age."

    Jones, who is dean of the University of Mississippi School of Medicine in Jackson, discussed the new guidelines in a phone interview. While he is an American Heart Association spokesman on blood pressure, Jones says he only treats adults in his clinical practice.

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