Children should be screened for high blood pressure at age 3

A new report from The National High Blood Pressure Education Program Working Group on Children calls attention to the role of hypertension in the current epidemic of obesity in children, and underscores the need for intervention.

The report, published as a supplement to the August issue of Pediatrics, urges primary care physicians to begin screening children for high blood pressure at age 3. This document updates the previous 1996 guidelines and is the fourth from this group.

According to Bonita Falkner, MD, chair of the working group, "The strong association of high blood pressure with obesity and the marked increase in the prevalence of childhood obesity indicate that both hypertension and prehypertension are becoming a significant health issue in the young." The guidelines recommend therapeutic lifestyle changes such as weight reduction, regular physical activity and restriction of sedentary activity to help prevent increases in blood pressure.

It is now widely accepted that cardiovascular health - or the lack thereof - originates in childhood. And today, nearly all primary care pediatricians measure blood pressure in children. But many doctors are still not familiar with the best way to evaluate and treat children with high blood pressure.

According to Dr. Falkner, "The evaluation of hypertension in children should also include assessments for additional risk factors such as diabetes and cholesterol disorders. In addition, physicians should take a sleep history due to an association of sleep apnea with overweight and high blood pressure."

In addition to children 3 years of age and older, the report recommends that blood pressure be measured in children younger than 3 years who were preterm infants, had a low birth weight and who had a difficult or prolonged hospital stay, as well as in children who have congenital heart disease, who are receiving medications that might increase their blood pressure, or who have any other condition that might lead to high blood pressure.