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Pediatric Hypertension

According to the American Academy of Family Physicians (AAFP), the development of a national database on high blood pressure in children has contributed to the recognition that there is indeed a rise in the number of children with elevated blood pressure. The complications associated with continued high blood pressure, like heart attack and stroke, make diagnosis and treatment of the condition a priority for parents.

There are numerous primary causes for pediatric hypertension, with obesity and renal problems accounting for the vast majority of cases. But one rarely identified factor is the “white-coat syndrome.”

Within the first few years of life, a child begins to understand that a doctor’s office is a “serious place.” The child may perceive that his mother feels stressed out, and the child then becomes stressed, raising blood pressure and providing the physician with a “false positive”: the child will have a blood pressure greater than the 95th percentile for age, weight, height, and sex, thus being diagnosed with high blood pressure when he does not have the condition.

If there are questions about the accuracy of the diagnosis, parents can opt to test their child’s pressure at home while the child is comfortable in a passive, but alert state, like watching TV. If he is playing video games or engaging in some other activity, the environment might be stressful and thus bias the resulting blood pressure reading, much like in the case of white-coat syndrome.

If your child’s blood pressure is indeed high, there are many preventive measures that can be used to lower it. There are a number of medications; but as with all illnesses, it is best to exhaust lifestyle changes before embarking on a pharmacological path.

The National Heart, Lung and Blood Institute (NHLBI) has outlined a diet-based method, “D.A.S.H.” (Dietary Approaches to Stop Hypertension),
to lower blood pressure.
(http://www.nhlbi.nih.gov/hbp/prevent/h_eating/h_eating.htm).

In addition to natural dietary changes, the NHLBI recommends lowering the salt and sodium intake, maintain an active exercise routine with 60 minutes of physical activity for your child every day. Unnecessary stress should be avoided as well.

Many parents ask about vitamin and mineral supplements to help their child’s blood pressure and other ailments, and although this is not often discouraged, it would be best to eat the natural foods which are high in these vitamins. For high blood pressure, the NHBLI recommends that parents focus on potassium intake for their children, as this has proven to be the most effective mineral for lowering risk of high blood pressure.
Harvard Health Publications confirms the finding.
(http://www.health.harvard.edu/fhg/updates/update0705c.shtml).

Additionally, the USDA has produced a list of foods that are high in potassium. (http://www.nal.usda.gov/fnic/foodcomp/Data/SR20/nutrlist/sr20w306.pdf.) As one might guess, fruits and vegetables top the list, with tomato products taking first place. Other high-potassium foods are: orange juice, white beans, leafy green vegetables, potatoes with skins, and various fish, including salmon, tuna and mackerel.

By Marc Courtiol

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