Presented by Edel Omondi - SAKIOM1911

HYPERTENSION
blood pressure that is at or above the 95th percentile for children who are the same sex, age and height

The younger a child is, the more likely it is that the high blood pressure is caused by a specific and
identifiable medical condition.

Pre-hypertension - BP persistently btwn 90-95%.children hypertension can either be primary or

secondary hypertension

Age Systolic BP Diastolic BP (in mmHg)

Toddler (1-2 yr). >115 >79

Preschooler (3-5 yr) >125 >85

Child (6-12 yr) >135. > 70

Adolescent (13-17 yr) >148 >100

Primary hypertension

Primary hypertension occurs on its own, without an identifiable cause. This type of high blood pressure
occurs more often in children age 6 and older. The risk factors for developing primary hypertension
include:

obesity

Having a family history of high blood pressure

Having type 2 diabetes or a high fasting blood sugar level

Having high cholesterol

Eating too much salt

Being Black or Hispanic

Being male

Smoking or exposure to secondhand smoke

Being sedentary

Secondary hypertension

Secondary hypertension is caused by another condition. It's more common in young children. causes of
secondary high blood pressure include:

Chronic kidney disease

Polycystic kidney disease

Heart problems, such as severe narrowing (coarctation) of the aorta

Adrenal disorders

hyperthyroidism

renal artery stenosis

Sleep disorders, especially obstructive sleep apnea

Pathophysiology

It involves the impairment of renal pressure natriuresis, the feedback system in which high blood
pressure induces an increase in sodium and water excretion by the kidney that leads to a reduction of
the blood pressure. Pressure natriuresis can result from impaired renal function, inappropriate
activation of hormones that regulate salt and water excretion by the kidney or excessive activation of
the sympathetic nervous system.

Nursing assessment

History: family hx of obesity,renal disease congenital heart defect prematurity tanussyndrome

Prolonged neonatal ventilation umbilical artery catheterization diabetes mellitus increased

intracranial pressure malignant solid organ transplant and medications

Symptoms
High blood pressure usually doesn't cause symptoms. However, signs and symptoms that might indicate
a high blood pressure emergency include:

Headaches

Seizures

Vomiting

Chest pains

Fast, pounding or fluttering heartbeat (palpitations)

Shortness of breath

Causes

High blood pressure in younger children is often related to other health conditions, such as heart
defects, kidney disease, genetic conditions or hormonal disorders.

Diagnosis

Do urinalysis to determine presence of kidney disease through; blood urea nitrogen

Serum creatinine

Renal ultrasound

ECG left ventricular hypertrophy

Lipid profile

Medical management

Angiotensin converting enzyme (ACE) - helps relax blood vessels by blocking formation of natural
chemical that narrow blood vessels eg Enalapril

Calcium channel blockers

Beta blockers eg propranolol

Thiazide diuretics eg chlorthalidone

Angiotensin ii receptor blockers

Nursing management

Providing a healthy diet low in salt intake

Encourage child to control portions size and reduce sugar intake

Advocate to increase physical activity

Teach child and family on how to administer antihypertensive when they need it

Through managing the condition that is causing the high blood pressure can help in controlling or
preventing hypertension