Pressure on docs to screen for hypertension in kids

What's a normal blood pressure for a 15-year-old boy? How about for an eight-year-old girl? Many physician's couldn't tell you taking children's blood pressure has never been standard practice. However, pediatricians may soon become familiar with normal blood pressure values for their patients, now that the American Academy of Pediatrics (AAP) has issued a recommendation that doctors routinely screen children for high blood pressure.

Given that one third of American children and teenagers are now overweight or obese, the AAP's aim is to prevent obesity-related health problems, such as diabetes, high blood pressure, heart disease, and even some cancers. As Dr. Reginald Washington, a pediatric cardiologist at Rocky Mountain Hospital for Children, points out, "The body doesn't forgive this; if you have high blood pressure or cholesterol as a child, you're setting yourself up for premature problems."

Failing to diagnose hypertension in a child can clearly have serious consequences: According to one estimate, about 2,000 children and teenagers suffer strokes each year as a result of hypertension. Yet medical experts note that many of these cases are probably preventable, provided that high blood pressure is diagnosed and treated early. And treating hypertension in children doesn't necessarily require medication: Lifestyle changes that bring about weight loss, and thus bring down blood pressure, are likely to do the trick.

The challenge, now, will be getting pediatricians to routinely screen for the condition. A recent review of data on children's blood pressure showed that, among kids who were eventually diagnosed with hypertension, only 26 percent of them had it noted in their medical records. And because a blood pressure reading that would be high for a child would often qualify as a normal value in adults, physicians may not even recognize the condition.

Both ACSH's Dr. Gilbert Ross and Dr. Elizabeth Whelan agree that blood pressure screening should become routine for children, given the preventive opportunities it allows. "Given the known serious repercussions of hypertension, doctors caring for children and teens need to check this parameter routinely in their patients; we should know the extent of the problem so we can take the appropriate measures," says Dr. Whelan.