BRUSSELS: Inactivity, high sugar and salt diets and being overweight account for 90% of high blood pressure cases in children and adolescents. A recent study of high blood pressure in children aged 6 to 16 gives families advice on how to improve their overall health.
The findings of the consensus document from heart health experts have been published in the European Heart Journal, a publication of the European Society of Cardiology (ESC).
“Parents are important agents of change in promoting children’s health behaviors,” said first author Professor Giovanni de Simone of the University of Naples Federico II, Italy. “Very often, high blood pressure and/or obesity coexist in the same family. But even when this is not the case, lifestyle changes should involve all family members.
Fresh produce, fruit, and other fiber-rich foods are encouraged in dietary guidelines for the treatment of high blood pressure in children. It is also advisable to minimize salt intake and avoid sugary drinks and saturated fats.
Children and teens should get no more than two hours of sedentary activity per day and should get at least one hour of vigorous physical activity per day, such as jogging, bicycling, or swimming. Simone’s teacher advised parents to keep an eye on how much time their children spend watching TV or using their smartphone and offer them active alternatives.
Setting realistic goals for weight, diet, and exercise should be done with a focus on the areas that need the most improvement. According to Professor de Simone, young people and their families can track progress towards their goals by keeping a long-term record of their weight, eating habits and physical activity without becoming obsessive.
It is advisable to implement a “healthy reward system”. “The ideal incentives are those that increase social support and reinforce the value of targeted behaviors, such as a family bike ride or a walk with friends,” said Simone’s professor.
According to the report, childhood obesity and hypertension are “insidious siblings” that turn into serious health risks over time. Studies show that childhood hypertension is on the rise, with obesity, particularly abdominal obesity, contributing to some of these increases. Less than 2% of normal weight children are thought to have high blood pressure, compared to 5% of overweight children and 15% of obese children. “The increase in childhood hypertension is of great concern because it is associated with the persistence of hypertension and other cardiovascular problems into adulthood,” said Professor de Simone.
It is essential to identify high blood pressure early so that it can be controlled through lifestyle changes and, if necessary, medication. A doctor or nurse can identify children with high blood pressure with a single blood pressure reading, but a second visit is advised for confirmation. Dr de Simone said: “Regardless of symptoms, screening should be done at least once a year in the primary care setting. This is due to the fact that hypertension in children, just like in adults, is usually asymptomatic.
A medical history and physical exam are needed to identify potential causes and identify behaviors that can be changed when blood pressure measurements indicate hypertension. Birth weight, gestational age, family history of hypertension and cardiovascular disease, lifestyle factors such as smoking, salt intake, alcohol consumption, physical activity and leisure activities, and Potential symptoms like headaches, nosebleeds, dizziness, visual disturbances, poor school performance, attention problems, shortness of breath, palpitations and fainting are all included in the information.
Early intervention for childhood hypertension should focus on behavior modification and education. Low dose medication should be started if blood pressure goals are not met. Small doses of two drugs may be needed if one drug is ineffective.
The authors urge public health organizations to make the prevention and treatment of hypertension in children and adolescents a top priority. For example, awareness campaigns on the dangers of high blood pressure in young people and the benefits of a healthy lifestyle including exercise, a healthy diet low in salt and sugar and quitting smoking. Other suggested actions include setting aside time for children to watch television and use social media without encouraging unhealthy eating habits or other potentially dangerous lifestyle choices.