Teenagers With High Blood Pressure? What?

twhbpJerrod was tall, muscular, and the best center fielder his high school baseball team ever had. So he didn’t give a second thought to the routine physical he had to have before the season.

“You’re generally in good shape,” said Dr. Parsons, “but your blood pressure is high. Well have to measure it again in a mountain or so.”

There was a moment of silence. Then Jerrod told the doctor it couldn’t be. Fifteen-year-olds don’t have a high blood pressure, especially healthy 15 years old like he was. Adults have high blood pressure, especially overweight adults like his dad and his grandfather. “Besides,” he said, “I’m not sure what high blood pressure means.”

The doctor explained that blood pressure is the force of a person’s blood against blood vessels, especially the arteries. It is expressed in two numbers.

The first number is the systolic pressure–when the heart is contracting. The second number is the diastolic pressure–when the heart is resting. In adults, blood pressure covers a range, and 120/ 80, or 120 over 80, is considered to be within normal range. Many people have blood pressure readings that are lower, and that is still normal. Anything over 10/90 is considered high blood pressure, or hypertension.

In children and adolescents, high blood pressure is defined in a different way. That’s because blood pressure in preadults increases with age. What’s normal for a 14-year-old would be high for a 6-year-old. So, high blood pressure in young people occurs when the pressure is above the 95th percentile for the person’s age and sex. That means that 95 percent of young people of the same age and sex have lower blood pressure. If blood pressure is between the 90th and 95th percentiles, it’s considered high normal.

Using this guideline, the National Heart, Lung and Blood Institute defines severe hypertension as more than 144/92 for adolescents ages 13 to 15 and more than 150/98 for adolescents ages 16 to 18.

An Early Start

Dr. Parsons said that hypertension, while much more common in adults, is a disease that originates in childhood. Until recently, experts thought that high blood pressure in children and adolescents was a sign of some other underlying problem. That’s called secondary hypertension. The most common underlying condition involves kidney function. Secondary hypertension is more common in children than in adults, but it’s still rare.

Doctors now know that a high reading can be a sign that a young person is developing essential, or primary, hypertension. That’s the most common type. It accounts for 95 percent of all hypertension and is present in more than one of four American adults. In children, essential hypertension is present more than a half the time when the blood pressure is elevated. The total incidence of hypertension in children has been placed at between 1.6 percent and 4.6 percent of the population.

Experts don’t understand the cause of essential hypertension, although they have isolated some risk factors–including obesity and a family history of high blood pressure. Research is ongoing to discover human genes that may make a person likely to develop hypertension. One research team has reported a gene that may affect blood pressure by influencing the way the body uses sodium. Medical experts have long warned that a high-salt diet may increase blood pressure. But only half of high-blood pressure patients seem to be affected by the amount of salt they eat. The discovery of the gene may explain why.

Jerrod was upset to hear that high blood pressure may be hereditary. “I guess there’s no way out. I’m just programmed to have it,” he told Dr. Parsons.

But the doctor explained some things that brightened the outlook. First, he hadn’t even completed his examinations of Jerrod’s blood pressure. A diagnosis of hypertensions is made only after three separate blood pressure readings done at different times. In patients without a history of elevated blood pressure, doctors recommended that blood pressure be measures once a year.

Second, heredity is not the only thing that influences blood pressure. Environmental factors are important, too–diet, weight, smoking, stress, exercise. Jerrod has a lot of control over these kinds of things.

In fact, when doctors treat hypertension, they begin by trying to modify these lifestyle factors. Only if that fails to bring the pressure under control do physicians prescribe the drug.

Lifestyle Choices

Diet. Lowering salt intake is only one dietary approach to controlling blood pressure. It’s also important to cut down on fats. A high-fat diet may contribute to high cholesterol, a waxy substance that becomes deposited in artery walls. Blood pressure increases when it must travel through narrowed vessels.

Some research suggests that potassium can lower blood pressure. It’s present in such foods as potatoes, bananas, and cantaloupe. Calcium has also been mentioned as a blood pressure regulator, but the research is sketchy.

Weight. Obesity, defined as weight that is 20 percent higher than normal, is probably the most common factor connected with essential hypertension, according to Dr. Michael Horan of the Heart, Lung and Blood Institute. The effects of excess weight on blood pressure can be seen in children as young as 2 years old.

Tobacco and other drugs. Smoking can aggravate high blood pressure by constricting blood vessels. So one of the first treatment approaches in smokers is to quit. Hormones pills may increase blood pressure. So may large amounts of caffeine taken by people who drink a lot of coffee or colas, or who use “stay awake” products.

Exercise. Exercising is one of the best ways to lose weight, control cholesterol buildup, and lower blood pressure. Regular aerobic exercise seems to be the best–at least 20 minutes three times a week. Power weight lifting may not be recommended since it can increase blood pressure. Participation in sports seems to be all right, except in cases of severe hypertension, but the final decision must be made with your physician.

Stress. In adults, studies have shown that stress management can reduced blood pressure. Treatment may include counseling to increase coping skills and such stress reduction techniques as deep breathing.

Drug Therapy

Most doctors try to control blood pressure without drugs, but if lifestyle changes don’t work, medication is the second line of defense. There are several types of drugs to control high blood pressure. Some work to remove excess fluid from the body. Some help dilate the blood vessels so that blood flows more readily. Others modify certain chemical reactions in the body. If one drug isn’t effective, or causes a bad reaction, others can be tried.

High blood pressure is a lifelong condition. So far, there’s no cure, but there are many ways to control it and even to prevent it. We know now that it’s a disease that starts in childhood. So you’re not too young to begin a healthy lifestyles and keep it from occurring at all.

The Measure of the Pressure

Blood pressure is measured with a device called a sphygmomanometer (sfig-mo-me-nam-et-er; sphygmo means pulse; manometer is an instrument for measuring the pressure of gases or liquids). The sphymomanometer consists of an inflatable band wrapped around the upper arm to compress the artery, and an attached manometer. The technician will be wearing a stethoscope.

When you’re having your pressure, sit in a comfortable position. The technician will wait a few moments until you get over your initial anxiety. In fact, blood pressure is often taken twice, and the second reading is sometimes lower because the patient is more relaxed.

Your arm will rest on a surface at heart level. The cuff will be wrapped around your upper arm and inflated. Then pressure within the cuff is released. As the pressure decreases, a clear tapping sound begins, which is heard through the stethoscope. This is the systolic blood pressure, which estimates the highest pressure of blood flowing through the arteries.

As the cuff is further deflated, there is a murmur of blood flow through the artery narrowed by the cuff. Then, still using the stethoscope, the sounds become crisper and more intense. As the cuff pressure decreases further, there are low-pitched, muffled sounds. The last phase is the disappearance of all sounds. That’s when diastolic pressure — as the heart rests — is measured.


1 Comment

One Response to “Teenagers With High Blood Pressure? What?”
  1. Janel Gillon says:

    High blood pressure on kids might be brought about by their unhealthy eating habits. Even if it is a family thing, the kids’ blood pressure can still be normalized if you make them accustomed to healthy eating.

Leave a Reply