High blood pressure in children and adolescents
Arterial hypertension is considered one of the most important risk factors for cardiovascular disease in adulthood. However, this clinical picture can already begin in childhood and lead to complications at an early stage. High blood pressure can be completely asymptomatic over a long period of time. Possible early symptoms include headaches, reduced performance, visual impairment or frequent nosebleeds. The causes of arterial hypertension in childhood can be of a primary nature, in which case it is referred to as essential hypertension. In this group, there is no underlying organic disease. In secondary hypertension, it is organic diseases that cause the increased blood pressure. In infancy and early childhood, organic secondary hypertension still predominates.
With advancing age, however, the frequency of primary, essential hypertension increases, accounting for over 50% of hypertension in adolescence. There are also risk factors that favour essential hypertension: Lack of physical activity, obesity, poor diet and a genetic disposition. An essential therapeutic step is an early change in lifestyle, including a change in diet. Excessive salt intake through the regular consumption of highly salted foods can also provoke high blood pressure.
Secondary hypertension is caused by various underlying diseases. It can occur in the context of kidney disease, aortic coarctation and also in the context of hormonal disorders.
Regular blood pressure checks by the paediatrician are an important step in the early detection of the disease. Special indications should cause increased vigilance: headaches, dizziness, visual disturbances, seizures, heart and kidney diseases, taking hormone preparations, any anaesthesia or surgery, high blood pressure in the family and sports medical examinations.
To measure blood pressure, a cuff is placed on the upper arm (of different sizes depending on the age of the child) and then the pressure of the blood flow in the vessels is measured. The highest value measured is called systole and the lowest value diastole.
In the 24-hour blood pressure measurement, the blood pressure is measured for 30 minutes over a period of 24 hours. This allows a daily blood pressure profile to be created.
Hypertension at growth age is diagnosed if the blood pressure is measured consistently above the 95th percentile in relation to body length. Translated with www.DeepL.com/Translator (free version)