This is a synopsis of an article first published in the New York Times.
In recent decades, due to our national addiction to fast food and sodium-bloated processed foods, there has been a drastic increase in elevated blood pressure, hypertension and obesity among children and adolescents. Roughly 17% of children ages 2-19 are obese and approximately 2 million children have been diagnosed with hypertension.
In August, the American Academy of Pediatrics published a 74-page report updating its guidelines for screening and managing high blood pressure in children and adolescents. The new guidelines include an easy-to-read chart to help physicians accurately determine a child’s blood pressure.
Child and adolescent blood pressure parameters and methods of measurement are different than those of adults. Prior to the new guidelines, normal blood pressure ranges were determined based on a child’s age, gender and height. The new guidelines, however, determine a child’s blood pressure (ages 3-18) based solely on a child’s gender and age.
Studies have shown that high blood pressure is properly diagnosed in less than one-quarter of the children who have an elevated pressure:
The largest study, published last year in the journal Pediatrics, covered more than 1.2 million patients ages 3 to 18. Electronic health records showed that 398,079 had their blood pressure measured at three or more visits. Of these, readings in 12,138 children met the criteria for hypertension and 38,874 for pre-hypertension (now called elevated blood pressure). But only 23.2 percent with hypertension and 10.2 percent with pre-hypertension were diagnosed as such and duly noted for follow-up in their health records.
If a child goes undiagnosed, elevated or high blood pressure can cause early “heart attacks, strokes and kidney disease,” and is a predictor for high blood pressure as an adult. High blood pressure runs in families, therefore, regular blood pressure screenings can help not only save the child’s life, but their family members’ lives, too.
The newly released guidelines strongly recommend that health care practitioners measure and record blood pressure readings at every well-check visit. Parents are urged to act as their child’s advocate by requesting blood pressure readings at every visit.
A diagnosis of “elevated or high blood pressure” is determined after three “consecutive” elevated readings. If a blood pressure measurement is elevated, the guidelines offer clear instructions including when to re-measure the child, advise dietary changes and prescribe increased physical activity for the child.
Dr. Flynn, chief of pediatric nephrology at Seattle Children’s Hospital says that most effective method of assessing high blood pressure in children (with an elevated pressure reading) is the use of an ambulatory blood pressure monitor (slightly larger than a smartphone) for 24 hours. Dr. Flynn explains that 30-40 percent of in-office high blood pressure readings are situational, caused by the child’s stress level at the doctor’s office. By using this device, Dr. Flynn reports a reduction in inaccurate diagnoses while saving money on unnecessary tests and/or drug therapies.
For more information on blood pressure guidelines for children and adolescents refer to the National Pediatric Blood Pressure Awareness Foundation.
Read the full article here.
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