Nine out of ten cases of high blood pressure in children and adolescents are caused by inactivity, a diet high in sugar and salt, and being overweight. A new study focusing on high blood pressure in children ages 6 to 16 advises families to improve their overall health.
The results of the consensus paper by heart health experts were published in the European Heart Journal, a journal of the European Society of Cardiology (ESC). (Also read: World Hypertension Day: survey finds fast food, pressure to perform makes children hypertensive)
“Parents are important actors in promoting healthy behaviors in children,” said lead author Professor Giovanni de Simone from the University of Naples Federico II, Italy. “It is very common for high blood pressure and/or obesity to run in the same family. But even if this is not the case, it is desirable that lifestyle changes involve all family members.”
Dietary recommendations for treating high blood pressure in children include emphasizing fresh vegetables, fruits, and other high-fiber foods, limiting salt intake, and avoiding sugar-sweetened beverages and saturated fats. Children and adolescents should engage in at least one hour of moderate-to-vigorous physical activity, such as jogging, cycling, or swimming, each day, and spend no more than two hours a day in sedentary activities. “Parents should monitor how much time their children spend watching TV or using smartphones and suggest active alternatives,” said Professor de Simone.
Set realistic goals for weight, diet and physical activity, focusing on those aspects that need to be improved the most. “Tracking weight, eating habits and exercise over time – but without becoming obsessive – can help young people and their families track progress towards their goals,” said Professor de Simone.
A “health-promoting reward system” is recommended. Professor de Simone said: “Ideal incentives are those that increase social support and reinforce the value of targeted behaviors, such as B. a bike ride with the family or a walk with friends.”
The document describes childhood obesity and high blood pressure as “insidious siblings” that are gradually becoming a serious health risk. Studies have shown that high blood pressure is becoming more common in children and that part of the increase can be explained by obesity, particularly abdominal obesity. It is estimated that less than 2% of normal weight children are hypertensive compared to 5% of overweight and 15% of obese children. Professor de Simone said: “The rise in childhood hypertension is of great concern as it is associated with the persistence of hypertension and other cardiovascular problems in adulthood.”
Diagnosing elevated blood pressure early is crucial so that it can be managed with lifestyle and, if necessary, medication. A blood pressure reading by a doctor or nurse can identify children with high blood pressure, but a second visit is recommended for confirmation. Professor de Simone said: “Screening should be carried out in primary care at least once a year, regardless of symptoms. This is because hypertension in children, like adults, is usually asymptomatic.”
When blood pressure measurements indicate high blood pressure, a medical history and physical exam are needed to determine possible causes and identify behaviors that can be modified. Information includes family history of hypertension and cardiovascular disease, birth weight and gestational age; Lifestyle information such as smoking, salt intake, alcohol consumption, physical activity and leisure activities; and possible symptoms such as headaches, nosebleeds, dizziness, visual impairment, poor school performance, trouble paying attention, shortness of breath, chest pain, palpitations, and fainting.
In the early stages, treatment for childhood hypertension should focus on education and behavior modification. If blood pressure goals are not met, a single low-dose drug should be instituted. If one drug is ineffective, small doses of two drugs may be needed.
The authors urge public health authorities to prioritize the prevention and treatment of hypertension in children and adolescents. For example, campaigns to raise awareness of the risks of high blood pressure in young people and the positive effects of a healthy lifestyle, including physical activity, a nutritious diet low in salt and sugar and not smoking. Other recommended actions include providing safe time for children on television and social media without promoting junk food or potentially harmful lifestyle choices.
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