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Generally, high blood pressure in children is not considered serious if transient or temporary. When high blood pressure in children is being caused by a separate underlying condition (secondary hypertension) the primary condition is the focus of treatment. In most cases, when the primary issue (e.g., obesity, kidney disease) is under control, then the child's blood pressure readings will return to normal. For children with high readings not due to another condition (primary or essential hypertension), treatment may be necessary. In such cases, treatment of high blood pressure in children is essentially the same as it is for adults. Hypertensive children will need treatment if they have any signs of organ damage such as:
- An increased thickness of the heart’s left ventricle (left ventricular hypertrophy)
- Retinopathy (a disease of the eye)
- Nephropathy (a kidney disease)
- Cerebrovascular disease (a brain-related disease)
Most hypertensive children can be treated using lifestyle modifications such as:
- Achieving and maintaining a healthy weight (a crucial step)
- Controlling diet, including lowering intake of fats and oils and salt and increasing fruit and vegetables
- Putting the child on the DASH diet (Dietary Approaches to Stop Hypertension)
- Exercising regularly (e.g., regular aerobic activity), but avoiding weight-lifting
- Controlling stress
- Avoiding caffeine
- Avoiding smoking and exposure to secondhand smoke
- Controlling diabetes (the combination of diabetes and hypertension can lead to serious medical complications in the future)
In children with severe and persistent high blood pressure that does not respond to lifestyle changes, antihypertensive medications may be recommended. While many of the same medications used in adults are also used for children, the dosage will usually vary.
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