Blood pressure is the force that your blood puts on your artery walls. High blood pressure, also called hypertension, happens when that force is consistently too high.
About four percent of youths 12-19 years old have high blood pressure, according to the Centers for Disease Control. Another 10% have blood pressure that is above what is considered optimal, but not high enough to diagnose as hypertension.
Detecting and treating high blood pressure is important because it can damage your circulatory system and increases your risk of having a heart attack, stroke, and other health problems later in life. Hypertension contributes to one out of every seven deaths in the U.S. In general, the longer you have high blood pressure, the greater the potential for damage to your heart and other organs including your kidneys, brain, and eyes.
Hypertension is a risk factor for developing serious health problems later in life. So, while high blood pressure risk increases with age, even teenagers should still pay attention to their blood pressure. Hypertension in young people is often linked to obesity.
Most people with high blood pressure aren’t aware of it because there are often no obvious symptoms. The only way to find out if you have high blood pressure is to get tested.
How is blood pressure measured?
Blood pressure was traditionally measured in healthcare settings using a blood pressure cuff with a pressure gauge (sphygmomanometer). This air-filled cuff wraps around the upper arm and obstructs blood flow. By releasing small amounts of air from the cuff, blood slowly flows back into the arm. The pressure measured inside the cuff is the same as the pressure inside the arteries.
There are two numbers measured for blood pressure. Systolic blood pressure is the pressure when your heart beats. Diastolic pressure is when the heart relaxes between beats and the pressure drops. Together, they are written as systolic over diastolic pressure. For instance, a blood pressure of 120/80 mm Hg (millimeters of mercury) corresponds to a systolic pressure of 120 and a diastolic pressure of 80.
Using a sphygmomanometer is still considered the best method but, more commonly, devices that combine a blood pressure cuff with electronic sensors are used to measure blood pressure. Another method is to have you wear a device that monitors and records the blood pressure at regular intervals during the day to evaluate blood pressure over time. This is especially helpful during the diagnostic process and can help rule out "white coat" hypertension, the high measurements that can occur when you are at the doctor's office and not at other times.
A single measurement of blood pressure is not enough to diagnose hypertension. Typically, multiple readings are taken on different days. A diagnosis of high blood pressure is made if measurements are consistently high.
A teen’s blood pressure may vary greatly between healthcare visits, or even within visits. So, it is important to obtain multiple measurements over time before diagnosing and treating children and teens for hypertension.
What is normal blood pressure?
High blood pressure for teens is defined differently than it is in adults. The 2017 American Academy of Pediatrics Clinical Practice Guideline recommends comparing a teen’s blood pressure to tables that take into account what’s normal for healthy youths of the same sex and height class. If a teen has blood pressure higher than 90 to 95 percent of other youths in their age and height class, then they may have high blood pressure.
Some risk factors for hypertension are especially relevant to teens. These include:
- Tobacco exposure (e.g. smoking cigarettes)
- Not getting enough exercise, inactivity
- Unhealthy diet
Some risk factors are related to things you can’t change, such as:
- African American descent
- A family history of high blood pressure
Others are lifestyle factors that are under your control including:
- Heavy alcohol drinking
- A diet high in salt
Sometimes medication, illegal drug use, or underlying conditions such as diabetes, kidney disease or thyroid disease, can cause hypertension. This is called secondary hypertension and treating these conditions, or stopping the medication, may remove the underlying cause of high blood pressure.
The 2017 American Academy of Pediatrics (AAP) Clinical Practice Guideline, endorsed by the American Heart Association, recommends annual blood pressure measurement for healthy adolescents.
The AAP recommends that adolescents with certain conditions have their blood pressure measured during every healthcare visit. The conditions include:
- Taking medication known to raise blood pressure
- Kidney disease
- A severe narrowing in the aorta, the major blood vessel carrying oxygenated blood to the body
The American Heart Association and American Thoracic Society’s 2015 guidelines on hypertension in children acknowledge that the causes of hypertension in teens are often different from those in adults. They focus on classifying the type of hypertension a teen has and determining treatment.
Sources (Last Review: 4/17/19)
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