What is high blood pressure (hypertension)?

Determining what blood pressure is acceptable and healthy for each individual can be a complicated process.  This is especially true for the many different sizes and shapes of children the same age.  When blood pressure is higher than what is considered normal or safe, this is called “hypertension”.

What is Blood Pressure?

Blood pressure is the pressure of the blood flowing through your body. A certain amount of pressure is needed to deliver blood and the nutrients and oxygen it carries to the parts of our bodies and carry the waste products away. Blood pressure can be measured. Through the work of the National Institute of Health and international investigators checking 10′s of thousands of children, we now know what normal blood pressure in children should be. Most visits to your doctor include having a blood pressure measurement performed. Many people have home equipment for measuring their own blood pressure and often you will notice a blood pressure measurement stand at your local drug store.

Can children have high blood pressure too?

As many as five out of each 100 (5%) children and adolescents may have high blood pressure.  Blood pressure rises with age.  For instance, as much as 50% of the elderly have high blood pressure. In Houston, Texas, for example, that means there are as many as 50,000 hypertensive children.

Facts about children and blood pressure

  • Hypertension is the most common cause of stroke, coronary heart disease, artherosclerosis, and kidney disease in adults. The effects of hypertension can begin during childhood.
  • It is possible to have high blood pressure for years without knowing. For this reason, high blood pressure is often called the silent killer.
  • Children who have high blood pressure tend to be hypertensive as adults.
  • Children with high blood pressure also often have other medical problems such as obesity, high blood lipids, and / or diabetes.
  • Children with high blood pressure are more likely to have a definable cause for high blood pressure (such as kidney disease) than adults.

How often should blood pressure be checked?

Your child’s blood pressure should be checked at least once per year.

Are there other times a child’s blood pressure should be checked?


  • If any other family members have been found to have high blood pressure.
  • If heart problems are suspected due to pain or pressure in the chest, feeling faint, or shortness of breath.
  • If your child has experienced sudden weakness or numbness of the face, arm, leg, or one side of the body.
  • If severe headaches, dizziness, unsteadiness, or falls occur.
  • If your child complains of pain in the lower back, swelling of the hands and feet, or an increased need to urinate.
  • If there has been a change in any existing high blood pressure medication.
  • Whenever your child sees their health care provider.

What can be done about my child’s high blood pressure?

Many possible approaches are available including:

  • Perform an ambulatory blood pressure monitoring (ABPM) to confirm that an elevated casual blood pressure is real.
  • Evaluate if there is a specific cause such as kidney disease for your child’s hypertension.
  • Evaluate if there are other indicators for cardiovascular disease such as high lipids, diabetes, or family history.
  • Evaluate if damage has already occurred to your child’s body due to hypertension.
  • Begin a non-pharmacological approach such as weight loss, exercise, salt intake reduction, stress reduction.
  • Begin an anti-hypertesive drug therapy if non-pharmacological approach is not sufficient or the hypertension is severe.
  • We encourage you to see a pediatric hypertension specialist in your area. For information, please feel free to email us.

When to refer to a Hypertension Specialist

  • When your patient has blood pressure values greater then 95th percentile for gender, age, and height on three different occasions.
  • When your patient has blood pressure values greater than the 90th percentile for gender, age, and height on three different occasions and has one or more risk factors of cardiovascular disease (e.g. obesity, diabetes mellitus, high blood lipids and / or family history of stroke, coronary heart disease or its risk factors).
  • When your patient’s blood pressure values in the clinic are inconsistent with blood pressure measurements in other settings.
  • When a patient with a confirmed diagnosis of hypertension has failed non-pharmacological management.
  • When documentation of blood pressure control by anti-hypertensive medication is required.
  • When comprehensive management with the latest anti-hypertensives, exercise, weight loss, and dietary support is indicated.