“Why does my 8 year old son have hypertension?”
My son is 8 years old and he was diagnosed with hypertension. Why does my 8 year old son have hypertension?
4 Answers
It is very uncommon for a person less than 12 years old to have high blood pressure. Therefore your son should be evaluated carefully to find the reason for high blood pressure. Some causes are serious and some are not so much--but the cause should be determined.
Visit your pediatrician and ask for a referral to an endocrinologist. Hypertension in patients less than 20 yrs old is usually due to abnormal hormone production from the adrenal axis
Runs in the family
Dear Concerned Mother,
This obviously must be very disturbing for you. Hypertension (also known as high blood pressure) used to be a disease of older folks in their fourties and up and often this is associated with life style. However, there are some genetic dispositions and there are some important issues such as coarctation of the aorta or a renal artery stenosis and many other issues that may cause high blood pressure at a young age.
The first order of the day is to verify that your child does not have white coat hypertension. White coat hypertension is a condition where your office blood pressure is elevated, but in fact, you do not have high blood pressure. This test involves a small programmable monitor attached to a proper size cuff which measures the blood pressure in the outpatient setting at school and at home over 24 hours. Measurements are done every 15 minutes during the day and every 30 minutes at night. This test is the gold standard for the diagnosis of hypertension. If the blood pressure load (values above the 95th percentile for the daytime and the sleep time) is over 40%, then you diagnose hypertension. If your doctor performed ambulatory blood pressure monitoring and this confirmed high blood pressure, then the diagnosis is probably real. If not, I would strongly recommend that you are referred to either a pediatric cardiologist or a pediatric nephrologist for assessment. There is no need to treat white coat hypertension. Your cardiologist or nephrologist may also examine the back of the eye of your child to look for changes due to long-standing high blood pressure and may ask for an ultrasound of the heart to look for thickening of the heart muscle. If any of these are abnormal, the high blood pressure may have been there for some time.
There are many reasons for high blood pressure. Whereas in overweight older folks this is most commonly "essential" hypertension, children have a long list of reasons, which have to be evaluated by a trained specialist. Most often, this is a pediatric nephrologist.
The most common reason today is obesity. There is a clear relationship between the blood pressure and the body mass index, which is a measure of the body composition. Treatment of obesity may help to ameliorate the high blood pressure, but this is not easy.
Another reason is salt (chemical name: sodium chloride). In the 1970s, children ate as little as 700 mg of sodium per day and today it is as high as 3700 mg per day. Nobody needs more than 2000 mg of sodium per day, which is one flush tablespoon of salt. Eating less than that is very difficult because 80% of the salt comes from processed food. The only way to get to a decent amount of salt per day is to cook everything from scratch with little or no salt. Eating out and purchasing prepared processed food makes it impossible to eat less than 2000 mg of sodium per day. Cheese, cold cuts and even bread (because we eat so much of it) are a major source of salt intake. The food industry adds a lot of salt to food to improve the shelf life.
Yet another reason is high fructose corn syrup, which is in all pop and sodas and also in many prepared foods. High fructose corn syrup is made from corn syrup, which is treated with an enzyme that converts glucose to fructose to make a consistent very sweet syrup that used to be cheaper than sugar. Fructose is a sugar with 5 C-atoms, whereas glucose has 6. Fructose can be converted to glucose (the sugar that feeds our brains) in the body, but only when fasting or when the glycogen stores in the liver are empty. Nobody fasts any more, and therefore the fructose goes into the beta oxidation and is immediately stored as fat. Moreover, fructose consumption raises the level of uric acid in the blood. This is bad as it can raise the blood pressure. I now check uric acid levels in every child with high blood pressure and often find it elevated. A doctor from Birmingham, AB, treated children with high uric acid levels and high blood pressure with a medication that lowers uric acid levels and normalized the blood pressure. There is no need to consume high fructose corn syrup (also called HFCS 55 and HFCS 44). HFCS 55 isi in all sodas, even though sugar is cheaper nowadays than HFCS 55. My advice is to read food labels and to avoid any food that contains high fructose corn syrup.
There are many other reasons. Some of these are weird and wonderful, for instance, some folks cannot tolerate black licorice. I would recommend that a specialist such as a pediatric nephrologist is consulted to work this up. Certain conditions such as coarctation of the aorta (a narrowing of the main blood vessel coming from the heart) or a narrowing in the arteries of the kidney can be treated and the high blood pressure problem can be cured.
I am hoping that your boy just has white coat hypertension, but please have this checked out thoroughly. High blood pressure is a silent killer. If left undiagnosed and untreated, this can lead to serious consequences including heart attacks, strokes, dementia and a short life expectancy.
Kind regards,
Guido Filler, MD, PhD, FRCPC
This obviously must be very disturbing for you. Hypertension (also known as high blood pressure) used to be a disease of older folks in their fourties and up and often this is associated with life style. However, there are some genetic dispositions and there are some important issues such as coarctation of the aorta or a renal artery stenosis and many other issues that may cause high blood pressure at a young age.
The first order of the day is to verify that your child does not have white coat hypertension. White coat hypertension is a condition where your office blood pressure is elevated, but in fact, you do not have high blood pressure. This test involves a small programmable monitor attached to a proper size cuff which measures the blood pressure in the outpatient setting at school and at home over 24 hours. Measurements are done every 15 minutes during the day and every 30 minutes at night. This test is the gold standard for the diagnosis of hypertension. If the blood pressure load (values above the 95th percentile for the daytime and the sleep time) is over 40%, then you diagnose hypertension. If your doctor performed ambulatory blood pressure monitoring and this confirmed high blood pressure, then the diagnosis is probably real. If not, I would strongly recommend that you are referred to either a pediatric cardiologist or a pediatric nephrologist for assessment. There is no need to treat white coat hypertension. Your cardiologist or nephrologist may also examine the back of the eye of your child to look for changes due to long-standing high blood pressure and may ask for an ultrasound of the heart to look for thickening of the heart muscle. If any of these are abnormal, the high blood pressure may have been there for some time.
There are many reasons for high blood pressure. Whereas in overweight older folks this is most commonly "essential" hypertension, children have a long list of reasons, which have to be evaluated by a trained specialist. Most often, this is a pediatric nephrologist.
The most common reason today is obesity. There is a clear relationship between the blood pressure and the body mass index, which is a measure of the body composition. Treatment of obesity may help to ameliorate the high blood pressure, but this is not easy.
Another reason is salt (chemical name: sodium chloride). In the 1970s, children ate as little as 700 mg of sodium per day and today it is as high as 3700 mg per day. Nobody needs more than 2000 mg of sodium per day, which is one flush tablespoon of salt. Eating less than that is very difficult because 80% of the salt comes from processed food. The only way to get to a decent amount of salt per day is to cook everything from scratch with little or no salt. Eating out and purchasing prepared processed food makes it impossible to eat less than 2000 mg of sodium per day. Cheese, cold cuts and even bread (because we eat so much of it) are a major source of salt intake. The food industry adds a lot of salt to food to improve the shelf life.
Yet another reason is high fructose corn syrup, which is in all pop and sodas and also in many prepared foods. High fructose corn syrup is made from corn syrup, which is treated with an enzyme that converts glucose to fructose to make a consistent very sweet syrup that used to be cheaper than sugar. Fructose is a sugar with 5 C-atoms, whereas glucose has 6. Fructose can be converted to glucose (the sugar that feeds our brains) in the body, but only when fasting or when the glycogen stores in the liver are empty. Nobody fasts any more, and therefore the fructose goes into the beta oxidation and is immediately stored as fat. Moreover, fructose consumption raises the level of uric acid in the blood. This is bad as it can raise the blood pressure. I now check uric acid levels in every child with high blood pressure and often find it elevated. A doctor from Birmingham, AB, treated children with high uric acid levels and high blood pressure with a medication that lowers uric acid levels and normalized the blood pressure. There is no need to consume high fructose corn syrup (also called HFCS 55 and HFCS 44). HFCS 55 isi in all sodas, even though sugar is cheaper nowadays than HFCS 55. My advice is to read food labels and to avoid any food that contains high fructose corn syrup.
There are many other reasons. Some of these are weird and wonderful, for instance, some folks cannot tolerate black licorice. I would recommend that a specialist such as a pediatric nephrologist is consulted to work this up. Certain conditions such as coarctation of the aorta (a narrowing of the main blood vessel coming from the heart) or a narrowing in the arteries of the kidney can be treated and the high blood pressure problem can be cured.
I am hoping that your boy just has white coat hypertension, but please have this checked out thoroughly. High blood pressure is a silent killer. If left undiagnosed and untreated, this can lead to serious consequences including heart attacks, strokes, dementia and a short life expectancy.
Kind regards,
Guido Filler, MD, PhD, FRCPC
