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Some Kids Under 3 Need Blood Pressure Checked

High Blood Pressure in Childhood Increasingly Common
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WebMD Health News

July 28, 2004 -- With childhood obesity sprouting an epidemic of health problems, doctors are being asked to check for and treat high blood pressure even in kids under 3.

New guidelines reiterate earlier recommendations that doctors routinely test blood pressure in all children starting at age 3. But now, an expert panel suggests that some children should be checked even earlier and provides more specific advice for treating high blood pressure in youngsters.

It's estimated that 1% to 3% of American toddlers and school-age children already have high blood pressure. That's at least 750,000 kids.

High blood pressure is called the "silent killer" because it usually causes no symptoms but can eventually lead to very serious consequences such as heart attack and stroke.

High Blood Pressure: Not Just for Obese Kids

"The obesity epidemic in childhood is making this more of an issue," says Bonita Falkner, MD, who led the expert panel drafting the new guidelines. "But even normal-weight children can have high blood pressure."

Falkner, professor of medicine and pediatrics at Jefferson Medical College in Philadelphia, tells WebMD that the new guidelines -- unveiled in May at the American Society of Hypertension annual meeting and to be published as a special supplement to the August issue of Pediatrics -- provide more information on how doctors should evaluate and treat high blood pressure in their youngest patients and urges them to keep a closer eye for other problems that can result from it.

"Before we advised doctors to screen children for high blood pressure starting at age 3 and keep an eye out for it, but there was little specifically addressing how to evaluate and treat it," she says.

Different Set of Numbers

In adults, high blood pressure is diagnosed when the top (systolic) number of a blood pressure reading is more than 140, or when the lower (diastolic) number is more than 90.

"But for young children, there is no one number that defines high blood pressure because there is a normal rise in blood pressure with growth and development," she tells WebMD.

Instead, doctors will use charts similar to "growth tables" that place children into groups for their height and weight. These charts will have blood pressure norms based on the child's age, sex, and height.

In addition to taking blood pressure readings of all children beginning at age 3, the guidelines recommend that blood pressure be routinely measured in younger children with certain conditions, including those born prematurely or at a low birth weight, those who had a prolonged hospital stay after delivery, those with heart disease, and those taking medications that can raise blood pressure.

Kids and a Change of Life

Under the guidelines, children in the 90th or above percentiles for their age have "prehypertension," suggesting the need for lifestyle changes. Those children, as well as some with mild high blood pressure, would typically be first treated with lifestyle medication similar to adults with either condition.

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