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Living Well

Children, Adolescents, and Hypertension

Last updated: Nov 12, 2015

Imagine hearing a diagnosis of hypertension at an annual checkup—for your child. Contrary to popular belief, high blood pressure is not just a risk for the middle aged and elderly. Children and adolescents can also suffer from hypertension, and this condition brings long-term risks for their health. A recent study shows that children with hypertension can become hypertensive adults. In fact, the number of children and adolescents with hypertension has been growing during the past decade.   Is your child at risk?

Causes of Hypertension in Children

There are two types of hypertension: primary and secondary.  Primary hypertension is usually caused by genetics.  Secondary hypertension is a symptom of another health problem. The causes of secondary hypertension in children vary but include:

  • premature birth
  • low birth weight
  • congenital heart disease
  • renal dysfunction (kidney problems)

In children without chronic health and issues, obesity is a frequent cause of hypertension and puts them at greater risk of diabetes and future heart problems. (1)

In fact, when children eat unhealthy foods—such as fast food—as a part of their regular diet, they can experience elevated blood pressure levels as early as age ten.  (2)

How is High Blood Pressure Defined in Children and Adolescents?

A child or adolescent is considered hypertensive when he or she consistently shows high blood pressure during repeated measurements.  The blood pressure must be “at or above the 95th percentile for sex, age, and height. How is high blood pressure detected in children?   One problem is that it is hard to detect because there are usually no symptoms in children and teens.  In order to have an accurate diagnosis, a physician may recommend a 24-hour blood pressure cuff, which measures blood pressure repeatedly and can give the data to establish if a child is truly hypertensive or not.

The National Heart, Lung and Blood Institute (NHLBI)—a division of the US Department of Health and Human Services—has issued standardized blood pressure tables that show the 50th, 90th, 95th, and 99th of height and weight for boys and girls.  Blood pressure between the 90th and 95th percentile in childhood is now termed “prehypertension” and is an indication for lifestyle modifications,” according to a report by the NHLBI. In other words, if your child’s blood pressure is higher than that of 95 percent of peers, it’s considered high.  Blood pressure changes as children grow older, so it is important that the comparison be made among children of the same age. A child or adolescent is considered hypertensive when he or she consistently shows high blood pressure during repeated measurements.  (3)

Steps to Take if a Child Is Hypertensive

“When children have hypertension because they are overweight and sedentary, I recommend a healthier diet and more exercise,” says Donald A. Leichter, MD, a pediatric cardiologist at Summit Medical Group. “I always start by recommending changes in lifestyle.”

Recommended lifestyle changes to lower blood pressure in children are similar to recommendations for adults.  They often involve increased activity, change in diet and gradual weight loss.  The easiest way to begin a healthy eating plan for children is to control what food you bring into your home.  This does not mean eliminating all foods that children love or putting a child on a rigid diet, which will only backfire.  There should be no forbidden foods; however, parents should be aware of the quality of their child’s food, and control the portion size.

  • Sugary snacks and sodas are special treats and should not be part of an everyday diet.  Don’t have them in your home as a staple.
  • Keep fresh fruit that you child likes on hand.
  • Another source of calories—and tooth decay—are sugary juices.  If your child drinks juice, dilute it with some water.
  • Swap out healthy ingredients for unhealthy ones in favorite foods.  Buy a whole wheat crust and make pizza with a hearty sauce and melting soy cheese. Instead of peanut butter and jelly sandwiches, serve apple slices and peanut butter for dipping.

Get off the Couch

Children should have at least an hour of activity a day.  This means play that raises their heart rate and makes them sweat.  Give your child a choice between TV or a video game, and keep it to an hour a day or less.  It’s important for families to be active together and for parents to be role models for their children.  Bicycling, family hikes, and playing in the yard are all healthy activities.  Check out the website Things to do in NJ for a list of recreational activities in New Jersey parks.

Unless hypertension is caused by a chronic medical condition, it is reversible.  For more information about kids and heart health, listen to Dr. Leichter’s podcast on SMG Radio.


1. Mayo Clinic. "High Blood Pressure in Children." Symptoms. The Mayo Clinic, 06 May 2015. Web. 29 Oct. 2015

2. ibid.

3. "The Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents." Pediatrics 114.2 (2004): 555-76. National Heart Lung and Blood Institute. Department of Health and Human Services, 3 Mar. 2004. Web. 29 Oct. 2015.