Teenagers With High Blood Pressure

Today, teenagers with high blood pressure (hypertension) are not uncommon. One in 25 children between the ages of 12 and 19 meets the diagnostic criteria for high blood pressure, while one in 10 has elevated blood pressure (previously known as prehypertension), which is a precusor.

There are medications able to lower blood pressure that teens can take. But lifestyle changes are the primary focus of their treatment, mainly because obesity is a main cause. This can include weight loss, a healthy diet, and routine exercise.

This article takes a closer look at the cause of high blood pressure in teenagers and describes the recommended treatment approaches for this younger age group.

Causes of High Blood Pressure in Teens

Hypertension is a chronic (long-term) condition that is associated with an increased risk of stroke, coronary artery disease, heart failure, and other serious medical conditions.

In the past, high blood pressure in young people was thought to be the result of kidney disease or some other condition that influenced blood pressure (referred to as secondary hypertension).

Today, health experts recognize that the overwhelming cause of high blood pressure in kids and teens is primary hypertension, a condition linked to an unhealthy diet, obesity, and physical inactivity.

Other factors can complicate hypertension in teens, including changes in hormones, rapid growth spurts, and smoking. So even if a teenager doesn't have the overt signs of obesity, their blood pressure reading may mirror those of peers who do have obesity.

According to the Centers for Disease Control and Prevention, roughly one in five teenagers in the United States (22.2%) have obesity. Many will go on to become adults with obesity, the rate of which today exceeds 40%.

Diagnosis of Hypertension in Teens

Although the definition of high blood pressure for children 12 and under varies based on how their readings compares to other kids in their age group, the same criteria used for adults apply to teenagers.

The American Heart Association currently classifies high blood pressure in teenagers and adults as follows:

• Normal: Systolic blood pressure under 120 mmHg and diastolic blood pressure under 80 mmHg
• Elevated: Systolic between 120 and 129 mmHg and diastolic under 80 mmHg
• Stage 1 hypertension: Systolic between 130 and 139 mmHg, or diastolic between 80 and 89
• Stage 2 hypertension: Systolic of 140 mmHg or greater, or diastolic of 90 mmHg or higher

Treatment of Hypertension in Teens

Because teens with a high body mass index (BMI) are at greater risk of heart disease in later life, the primary focus of treatment of hypertension is placed on reducing weight and making healthier lifestyle choices.

While adults with hypertension are typically prescribed antihypertensive drugs when their risk of heart disease is high, children and teens with hypertension are more commonly advised to take aggressive steps to reduce their blood pressure with lifestyle changes.

The lifestyle changes would involve the following combination of interventions:

• Eating a healthy diet rich in fruits and vegetables and lower in sodium (salt) and saturated fat
• Maintaining a healthy weight based on agreed-upon goals with your healthcare provider
• Exercising regularly with age-appropriate activities
• Quitting cigarettes, if applicable
• Eliminating drug and alcohol use, if applicable

Antihypertensive drugs may be needed for children and teens with stage 2 hypertension if lifestyle interventions are not able to bring their blood pressure under control.

At present, there are no strong recommendations as to which types of drugs are more appropriate for children and teens with hypertension.

Every effort should be made to start at the lowest possible dose and to increase the dose gradually if needed to bring the blood pressure within the optimal range. This should only be done under the advise of a healthcare provider.

Medications are not a replacement for weight loss, exercise, and other healthy lifestyle choices.