Hypertension In Children … Myth Or Reality?
Over the years, attention on hypertension has been focused more on adults as compared to children.
It is very common to see adults being checked for blood pressure when they visit health facilities for a regular check-up, this rarely happens in children when they visit health centres.
However, children often get their blood pressure checked when they are in a serious condition of sickness.
Also education and campaigns from governments, non-governmental organsations, researchers, health facilities and individuals on hypertension are common in adults as compared to children.
Likewise, media reports and articles are focused on hypertension in adults than children.
Does this go to suggest that there is no hypertension in children or hypertension in children is a myth?
According to United Nations Children’s Fund (UNICEF), a child means every human being below the age of 18 years unless under the law applicable to the child, majority is attained earlier.
According to a Medical Officer at the Pentecost Hospital, Tarkwa, Doctor Nicholas Addae Mensah, children also suffer from hypertension, both primary and secondary hypertension.
He stated that, a child is diagnosed with hypertension when their average blood pressure is above the 95th percentile for their age, sex, body size and height when measured multiple times over three visits or more.
For toddlers, that is likely to be 98 systolic BP over 52 Diastolic BP (98/52 mmHg) or above, for children three to five that tends to be 100/55mmHg or above and for children from six to 12 that is likely to be 105/66mmHg or above.
The medical officer said the normal blood pressure in children is 50th to 90th percentiles, however, he said any figure below or above the said figures means the child has a problem with his or her blood pressure.
“Any child with an average blood pressure at or above the 95th percentile from multiple readings taken over several visits has hypertension,” he stated.
He said hypertension is not only limited to adults but children also suffer from hypertension.
Dr Mensah highlighted that, a child at any age can suffer from hypertension, once there are exposed to any risk factor or an underlining health condition.
Dr Mensah, who is also the President of Youth Network for Health Promotion, said there is a recommendation that, all children from three years and above must have their BP checked regularly.
However, children below three years, with certain health conditions, such as premature babies, babies born with heart conditions, babies with low birth rates that is below 1.5 kilograms, when the child is under intensive care, proteins in the baby’s urine among others should also have their BP checked.
He also added that children who are on medications that can cause the BP to rise must be checked regularly until they are off that medication.
According to him, five per cent in every 100 children has hypertension but out of 100 overweight children about 30 per cent of these children have hypertension.
This he said means that obesity was a modifiable risk factor of hypertension in children that is a child who is overweight has a higher risk of suffering from hypertension.
Mr Mensah revealed that the reason why children do not get their BP checked regularly is due to the lack of pediatric Blood Pressure (mercury sphygmomanometer) machines in most health facilities in the country, which calls for concern.
Overweight being the major risk factor of hypertension in children, the immediate past Director of Nutrition at the Ghana Health Service, Ms Esi Foriwa Amoaful, said overweight and obesity among children were a result of the consumption of fatty and junk foods.
According to the Ghana Health Service, more than 800 children were diagnosed with diabetes in 2021 in three major teaching hospitals in the country; namely Korle-Bu, Okomfo Anokye and Cape Coast.
She advised parents to feed their children with healthy foods, fruits and vegetables.
“Prepare food at home with more vegetables. Blend your own fruit and vegetables to make fruit drinks for them, so as much as possible feed them locally available foods which are rich in nutrients,” she recommended.
Ms Amoaful said fruits and vegetables were great sources of vitamins and minerals which help develop the general well-being of children.
Risk factors
A child’s risk factors for hypertension depend on health conditions, genetics and lifestyle factors.
Essentially, these risk factors are in two forms namely, modifiable, which causes primary hypertension and non-modifiable, which also causes secondary hypertension.
The modifiable risk factors include, a child who is overweight, has high cholesterol, family history of hypertension, type two diabetes, eating too much sugar, exposure to smoke among others.
Whilst, the non-modifiable among others are, a child having chronic kidney disease, Polycystic kidney disease, heart problems, adrenal disorders, overactive thyroid, narrowing of the artery to the kidney and sleep disorders.
Symptoms
A child who is suffering from hypertension emergency will have symptoms like headaches, seizures, vomiting, chest pains, fast pounding or fluttering heartbeat.
This child’s breath turns to be shortened and inconsistent, as he or she finds it difficult to breathe.
Prevention
It is always appropriate to see a cardiologist for diagnosis based on the child’s risk factor, however, because hypertension in children is often a symptom of another condition or illness, any child with hypertension needs to undergo an evaluation to search for an underlying cause.
It is also a recommendation that, children need to see a nephrologist for diagnosis and treatment since kidney disease is the main cause of high blood pressure and hypertension in children.
Parents need to help their children adopt a weight loss lifestyle by exercising through play like jumping, playing football, playing tennis, swimming, racing among others.
Parents also need to watch their children’s diet by regularly giving them fresh vegetables, fruits and low-fat dairy, minimal to no sugar-sweetened drinks and eliminate empty calorie drinks like juice, soda and sweet tea.
Children should drink plenty of water regularly.
Parents should target their children’s intake of salt to not more than 1,500 mg sodium per day and limit cholesterol intake to less than 300 mg each day.
Children should not be exposed to smoking and secondhand smoking as it causes ear infections, coughs and colds and respiratory problems such as bronchitis and pneumonia, which can increase a child’s factor of getting hypertension.
If a child has an underlying medical condition that affects the kidneys, keep up to date with medical appointments to ensure the child is monitored regularly for hypertension.
Recent studies suggest that childhood hypertension represents a considerable public health challenge worldwide.
According to the World Health Organisation (WHO), cardiovascular disease (CVD) alone accounts for approximately 17.9 million NCD deaths annually.
The risks are not only evident in adults, but also in children. Obesity in children and adolescents in Southern Africa has shown the largest proportional increase globally with a staggering 400 per cent increase per decade.
Studies have also revealed that, in adults presenting with hypertension, around half had elevated BP in childhood. Additionally, elevated BP in childhood has been shown to predict increased adult cardiovascular disease and mortality, including coronary heart disease and stroke.
Furthermore, the risk factors for pediatric elevated BP, such as obesity, may also trajectory into adulthood, highlighting the importance of interventions at an early age.