When and How Should Blood Pressure be Measured in Children?

Question: When and How Should Blood Pressure be Measured in Children?

Answer:

There's been a recent disturbing upward trend in the number of children being diagnosed with high blood pressure, and many experts think that blood pressure isn't being measured often enough in most children. Currently, doctors recommend that for children older than 3 years, blood pressure should be measured at each scheduled visit to the doctor. In general, children younger than that only need regular blood pressure checks if they:

• Are seriously overweight or underweight
• Stayed in the ICU (intensive care unit) for any amount of time after birth
• Have/had any known heart, lung or circulatory problems
• Experienced any complications or difficulty before, during, or shortly after birth

The blood pressure readings taken at the doctor’s office will become a part of your child’s medical record, and will allow your doctor to track blood pressure trends over time in order to more easily detect any potential problems.

Measuring Blood Pressure in Children

The proper technique for taking a blood pressure reading in children is the same as for measuring blood pressure in adults. As in all patients, proper measuring technique is essential for obtaining accurate readings. One large study that looked at how well doctors and nurses perform the task of measuring blood pressure found that even small errors in measuring technique can skew readings by as much as 10%-15% -- enough to create concern when things are actually fine, or prevent further investigation when it should be made. Specific attention should be paid to:

• Cuff size – an incorrectly sized cuff will give falsely high or falsely low readings
• Timing – blood pressure should be taken after the child has been relatively calm for at least 5 minutes
• Repetition – at least two separate readings should be taken during each visit to the doctor. While these readings must be taken at least two minutes apart, there is some data to suggest that taking the readings at the beginning and end of the appointment may provide better results
• Consistency – blood pressure readings should be taken by the same person whenever possible. On a single visit to the doctor’s office, the same person should perform both readings for that day

Read More About: Proper Technique for Measuring Blood Pressure

_Sources:

1. Pickering, TG, Hall, JE, Appel, LJ, et al. Recommendations for blood pressure measurement in humans and experimental animals: part 1: blood pressure measurement in humans: a statement for professionals from the subcommittee of professional and public education of the American Heart Association Council on High Blood Pressure Research. Circulation 2005; 111:697.
2. Williams, CL, Hayman, LL, Daniels, SR, Robinson, TN. Cardiovascular health in childhood: A statement for health professionals from the Committee on Atherosclerosis, Hypertension, and Obesity in the Young (AHOY) of the Council on Cardiovascular Disease in the Young, American Heart Association. Circulation 2002; 106:143.
3. Recommendations for routine blood pressure measurement by indirect cuff sphygmomanometry. American Society of Hypertension. American Journal of Hypertension 1992; 5:207.
4. Beevers, G, Lip, GY, O'Brien, E. ABC of hypertension. Blood pressure measurement. Part II – Conventional sphygmomanometry: Technique of auscultatory blood pressure measurement. BMJ 2001; 322:1043.
5. Gillman, MW, Cook, NR. Blood pressure measurement in childhood epidemiological studies. Circulation 1995; 92:1049.
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