The Epidemic of High Blood Pressure in Kids and Teens

Although we usually think of high blood pressure (or hypertension) as a condition that primarily affects adults, the number of American kids and teens who have it has been growing steadily since the late 1970s.

What Is High Blood Pressure?

High blood pressure, also known as hypertension, is a condition where the force of blood pushing through the walls of the arteries is regularly too high. Healthcare workers measure blood pressure with two numbers: the top number is the body’s systolic pressure, and the bottom represents the diastolic pressure. Systolic pressure is the measure of when the heart pumps blood; diastolic pressure records the intervals at which the heart rests in between each beat. One of the biggest risk factors for hypertension – regardless of age – is obesity. Other risk factors include a sedentary lifestyle, too much sodium, certain medical conditions, caffeinated and/or sugary energy drinks, alcohol use, tobacco use, poor nutrition, poor sleep, and certain genetic factors.

According to the Centers for Disease Control and Prevention (CDC), childhood obesity hovered around 5% in the 70s. By 2020, the average had grown to almost 20%. As more and more of America‘s youth became obese, the number of cases of hypertension and elevated blood pressure also went up. Elevated blood pressure, or blood pressure that is above normal but below hypertension, is a condition that increases one’s likelihood of developing high blood pressure later in life. The American Academy of Pediatrics (AAP) current estimates suggest that as many as 5%, or 3.6 million, children and teens under 18 years old have hypertension. In addition, 10% more, or roughly 7.3 million, have elevated blood pressure.

Why Is High Blood Pressure So Dangerous?

Although we have long-associated hypertension and elevated blood pressure as a condition unique to older adults, it was not too long ago that the American Heart Association (AHA) released a statement warning medical providers, parents, and caretakers that these “often unrecognized” conditions are by far more common in younger individuals than we previously suspected. The reason that elevated blood pressure and hypertension create so many dangers is because they put extra stress on the body’s cardiovascular system and kidneys, leading to vascular aging. Vascular aging can cause stiffening of the blood vessels and enlargement of the heart muscle. Not only can high blood pressure cause damage to a person’s heart and kidneys, but also to their eyes and brain. If left untreated and unmanaged, elevated blood pressure and hypertension can lead to other serious medical conditions like kidney disease, heart disease, and stroke.

Screening and Treating Elevated Blood Pressure and Hypertension in Kids and Teens

Back in 2017, providers missed up to 75% of elevated blood pressure and hypertension diagnoses in pediatric patients in primary care settings (AAP). Although the AAP recommends that providers make measuring blood pressure in children a routine part of wellness checks beginning at the age of three – in fact, this has been an official recommendation from the academy for nearly a decade now – pediatric health advocates say many providers have still not implemented it into their practice. Failing to follow the standard of care by not screening children appropriately is not only unethical, but it puts them at risk of experiencing a potential onslaught of serious and debilitating medical complications in the future.

For children 13 and below, an elevated blood pressure reading is higher than the 90^th percentile for the child’s age, gender, and height. High blood pressure, or hypertension, is in the 95^th percentile for their age, gender, and height. For teens 13 and older, elevated blood pressure is 120-129/80, and high blood pressure is at or above 130/80. Here are some examples of the AAP’s blood pressure screening guidelines that providers should have as a regular part of their practice:

• Blood pressure should be measured every year in patients three years and older.
• Blood pressure should be measured at every appointment for patients who are obese, have renal disease, diabetes mellitus, or a history of aortic obstruction or coarctation, or who are taking medications associated with high blood pressure.
• Ambulatory blood pressure (or a test that measures blood pressure over a period of time where the patient is moving around and doing their normal activities) should be performed in the setting of suspected white coat hypertension, elevated category of blood pressure for at least one year, or with stage 1 hypertension at three separate office visits. White coat syndrome is when a person’s blood pressure is significantly higher when measured in a doctor’s office as compared to at home; this is usually due to anxiety. Stage 1 hypertension refers to a blood pressure reading in the range of 130-139/80-89.
• The goal of treatment in children should be to reduce systolic and diastolic blood pressure to less than the 90^th percentile and less than 130/80 in those 13 and older.
• If your child has high blood pressure accompanied by dizziness, severe headache, blurred vision, chest pain, shortness of breath, nausea, vomiting, confusion, seizure, and/or a blood pressure reading significantly above the 95^th percentile of their gender, age, and height, you should take them to the hospital or call 9-1-1 immediately.

Although measuring blood pressure in children and teens poses different difficulties than measuring blood pressure in adults, there are strategies and tools that providers can use to make the process easier and more accurate. Some examples of these include:

• If the initial blood pressure reading is abnormal, wait and take the reading two more times. Then, average the total between the three.
• Determine which percentile the child is in based on age, gender, and height, then consult the standardized table to assess which blood pressure category they are in. Children grow constantly, so it is crucial that providers stay on top of their measurements.
• Some providers have started using software that sends an alert and tells personnel to take two additional readings when a blood pressure reading is abnormal. According to the AAP, the best practice alert system was built using an electronic health records system called Epic Software.
• Parents and caregivers should advocate on their child’s behalf: insist that your child’s provider takes their blood pressure, especially if you have a history of elevated blood pressure or hypertension in your family.

High blood pressure may be scary, but it can be managed. Lifestyle changes like eating a healthy diet that is low in sodium, getting regular physical activity, avoiding tobacco and alcohol, maintaining a healthy weight, getting adequate sleep, and managing stress are all effective ways that a person can lower their blood pressure. To start your family’s journey of making positive, low blood pressure-friendly lifestyle changes, make an appointment with your child’s pediatric care provider today.

Contacting an Attorney

Every year, hundreds of thousands of Americans are injured or killed by preventable medical mistakes. Medical malpractice occurs when a doctor, hospital, or other type of medical provider deviates from the accepted standard of care – like failing to uphold the AAP’s guidelines of taking blood pressure readings for children starting at the age of three – and a patient is harmed as a result. Some of the most common types of preventable medical errors include misdiagnosis, delayed diagnosis, failure to treat, and surgical errors.

If your child or teen experienced elevated or high blood pressure-related medical complications and you have questions about filing a malpractice claim, someone at our firm can help. If you would like to learn more, contact a representative online now.

Philadelphia Medical Malpractice Lawyers at Galfand Berger, LLP, Representing Injured Victims Since 1947

Contact the Philadelphia medical malpractice lawyers at Galfand Berger LLP today. Call us at 800-222-USWA (8792) or fill out our online form for a free consultation. Located in Philadelphia, Bethlehem, Lancaster, and Reading, we serve clients throughout New Jersey and Pennsylvania, including Allentown and Harrisburg.