Lifestyle disorders — High blood pressure
HIGH BP (Hypertension):
Hypertension can be defined as average systolic BP and diastolic BP more than 95th precentile for gender, age and height.
At least 3 independent resting BP readings should be taken with the appropriate sized BPcuff standardized as per the size of the arm.
Pre Hypertensionm can be defined as readings between 90th and 95th percentiles and such children need further monitoring.
HT in adolescents is commonly associated with raised BMI and positive family history of HT.
Causes of secondary HT like hormonal abnormalities, renal artery stenosis, other renal disorders,t umours etc need to be excluded in children with severe Hypertension.
Symptoms include headaches, dizziness and breathlessness. Thorough physical examination and at least 3 accurate BP recordings are essential.
24 hour ambulatory BP studies are useful to confirm diagnosis and exclude `white coat HT`
Blood investigations for sugar, lipids, ECG, 2 D Echo, eye examination and renal sonography should be carried out.
Treatment includes changes in diet with avoidance or junk food, reducing salt intake and aerated drinks, and switching to a healthy low fat diet of fruits and vegetables.
Regular aerobic exercise and maintaining healthy weight is useful.
Drug treatment can be initiated for significant uncontrolled Hypertension with proper monitoring and using anti – HT drugs approved for use in children.
Techniques for relieving stress – meditation, yoga and deep breathing exercises can also help in the long term.