The rise in childhood obesity has focused attention on a spate of new health problems for children, including high blood pressure. About 5 percent of children have high blood pressure, which puts them at an increased risk for heart attacks, stroke, and health problems later in life. In response, experts convened by several national organizations evaluated the current research and developed recommendations for treating child and adolescent high blood pressure.

What the authors wanted to know: What does the latest research tell us about high blood pressure in children, and how should high blood pressure be treated?

What they did: Members of the National Heart, Lung, and Blood Institute and the National High Blood Pressure Education Program decided that they needed to update a 1996 report on high blood pressure in children and adolescents. They convened some of the most highly regarded doctors and scientists in the field to address current issues and research. Working groups met and wrote sections of the report on the definition, measurement, and treatment of high blood pressure in children.

What they found: Based on current research and the increase in childhood obesity (which is associated with high blood pressure) the authors recommend that all children older than 3 have their blood pressure taken every time they visit the doctor. Worrisome blood pressure, they say, is anything that falls above the 90th percentile range for a child's height and age, though an elevated blood pressure should be confirmed by a follow-up visit to make sure it isn't just a temporary spike. Children with high blood pressure often have other cardiovascular conditions, so the authors recommend a full physical examination and particularly emphasize asking questions about a child's sleep, which can be signs of other diseases. The authors also said that secondary hypertension, high blood pressure due to another disease such as kidney disorder, is more common in children than in adults and so doctors should work to try to establish a cause of the child's high blood pressure.

What it means to you: National groups of experts do not often convene to re-evaluate the definition and treatment of medical conditions, and when they do, other doctors should listen. One recommendation that doesn't require a doctor: lifestyle modifications, including exercise, a healthy diet, and weight loss for obese children. The report says that, though research into diet and exercise patterns as a way to reduce blood pressure in children is limited, learning to eat well and exercise frequently will reduce the risk for high blood pressure in adulthood.

Caveats: When the leading experts in a field meet, debate, and analyze research, they don't miss much.

Find out more: KidsHealth, a nonprofit organization, has a page with facts about children and high blood pressure.

The American Heart Organization also has an explanation of what happens to the heart when a person has high blood pressure and why that can be dangerous.

Read the article: National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents. "The Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adults." Pediatrics. August 2004, Vol. 114, No. 2, pp. 555–576.

Article online: http://pediatrics.aappublications.org