For years, the hypertension has earned the nickname the “silent killer“. It is a pathology that barely causes symptoms, but can cause serious damage in the heart, brain and blood vessels. Traditionally, it has been associated with older people, whose arteries age and accumulate atheromatous plaques over time. But that is changing: More and more children are living with high blood pressure.
Taking blood pressure in the little ones in the house is something that for many may be unthinkable, because it is something that is logically assumed to be perfect because their arteries are also very young. But it’s changing, according to a study published in The Lancet Child & Adolescent Health.
How many. The data are worrying: the percentage of children and adolescents with hypertension has almost doubled in two decades: from 3.2% in 2000 to more than 6.2% in 2020. This means that 114 million children under 19 years of age in the world today live with high blood pressure.
This photograph results from an analysis of 96 different studies and 443,000 young people from 21 countries.
The reasons. So… Why on earth does a child have a disease that is associated with older people? The person responsible is in obesity which is associated with an almost eight-fold increased risk of developing high blood pressure compared to their peers with a healthy weight. And the figures in this case are devastating.
To give us an idea, among children who have a healthy weight, only 2.4% have hypertension. But this counteracts with children who do have obesity, where the figure shoots up to 19%.
This is further amplified when childhood obesity is increasing globally and has tripled since 2000 as has recognized UNICEF. And the causes in this case seem to be in the high consumption of processed foods and also in the low physical activity that some young people have.
Diagnose in time. Although the study recognizes the limitations that arise in the differences in measuring blood pressure, the message is quite clear: blood pressure must be taken when risk factors such as obesity are present. We must remember that we are talking about a ‘silent killer’, because it seems that everything is correct, but damage to the arteries is occurring.
The most important thing, like any other disease, always is early diagnosis to be able to apply measures to control the situation and prevent it from advancing much further.
The problem of measurement. One of the most revealing findings of the study is that How we measure blood pressure matters, a lot. Prevalence figures change drastically depending on the diagnostic method.
A priori, the diagnosis in a medical consultation requires at least three office visits for hypertension to be confirmed, causing the prevalence to be estimated at 4.3%. However, when the researchers included out-of-office evaluations (like the classic blood pressure monitors that anyone can use), the prevalence of sustained hypertension shot up to 6.7%.
It’s a problem. This paradigm shift suggests that there are children who have normal tension when they go to the doctor, but it increases in their daily lives. Something alarming, especially considering that it affects 9.2% of children and adolescents globally and that is why we should not allow this masked hypertension.
In the opposite case, blood pressure is elevated in the medical environment due to stress, but is normal at home, something known as ‘white coat hypertension‘. This affects 5.2% of young people, suggesting that a notable proportion could be being misdiagnosed or overtreated.
Prehypertension. The study not only looks at children who are already hypertensive, but also at those who are in the waiting room. Data show that an additional 8.2% of children and adolescents have prehypertension, that is, blood pressure levels higher than normal, but do not yet meet the criteria for diagnosis.
But this risk is not homogeneous. Prehypertension is especially prevalent during adolescence, reaching 11.8% of adolescentscompared to 7% in younger children.
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