Just a couple of decades ago, complaining about high blood pressure was the lot of older and elderly people. Today, arterial hypertension has become younger, like many diseases, due to the costs of today's lifestyle and level of workload. Increasingly, the diagnosis of hypertension is being made to young people 20-30 years old. The vast majority of cases of persistent increases in blood pressure are caused by one or another pathology of the cardiovascular system. In approximately 5-10%, the reason lies in the development of complications due to renal or endocrine diseases. A blood pressure of 120/80 mmH is considered normal at a young age. rt. Art. or slightly lower (of course, individually determined deviations from the norm are possible). Blood pressure readings up to 140/90 are considered a prehypertensive state, 140/90 – 160/100 indicate stage 1 hypertension, and above 160/100 indicate stage 2 hypertension. In this case, we are not talking about infrequent episodic rises, for example, against the background of emotional stress.
The problem of hypertension at a young age has two negative aspects. First, in young patients, arterial hypertension may not produce significant symptoms for a long time; second, even in the presence of clearly defined signs of hypertension, a young person quite often ignores the need to visit a doctor and long-term constant treatment and the need to maintain a healthy lifestyle.
Dear patients!
Arterial hypertension (AH) is currently the greatest non-infectious pandemic in human history, determining the structure of morbidity and mortality in the adult population, and its origins are usually found in adolescence.
Hypertension is an independent disease and one of the main risk factors contributing to the development of coronary heart disease, myocardial infarction, stroke and, ultimately, disability and mortality.
The appearance of high blood pressure in adolescence is fraught with the risk of its persistence in subsequent years and an unfavorable prognosis for the occurrence of the above-mentioned cardiovascular diseases.
According to the World Health Organization, arterial hypertension affects more than 1 billion people worldwide, in Europe – about 44% of the population. This problem is also relevant for Belarus. In children and adolescents, hypertension is relatively uncommon and ranges from 2.4 to 18% with age.
Normal blood pressure (BP) is taken to be the values of systolic and diastolic blood pressure corresponding to the gender, age and physical development of the child, determined using special tables. For children and adolescents, it fluctuates and changes depending on age. For example, in a 14-year-old boy with a height of 165 cm, blood pressure can fluctuate within the following limits: systolic blood pressure - from 102 to 125 mm. rt. Art., diastolic blood pressure – from 61 to 78 mm. rt. Art.
The formation of hypertension in children and adolescents can be caused by various factors and causes.
Hypertension can be primary (essential) and secondary (symptomatic).
Primary hypertension is an independent disease. Its cause may be:
hereditary predisposition;
psychosocial stress (increased nervous mental stress);
sedentary lifestyle;
inadequate work and rest regime;
smoking, alcohol abuse;
physiological mechanisms (complex disorders of metabolic processes in the body).
Secondary hypertension in children in most cases occurs against the background of certain diseases:
kidneys (about 70%);
endocrine system (Itsenko-Kushirnga syndrome, thyrotoxicosis, pheochromocytoma, etc.);
cardiovascular system (aortic caorctation, aortic stenosis, aortic valve insufficiency, patent ductus arteriosus), etc.
The main symptom of hypertension is increased blood pressure. Patients may complain of headaches, pain in the heart, poor health, irritability, fatigue, sweating, dizziness, tinnitus, flashing spots before the eyes, nausea, vomiting, nosebleeds.
To avoid untimely detection of hypertension in children, it is recommended to measure blood pressure at the age of 3 years (before entering a nursery school, kindergarten), 1 year before school (5-6 years), immediately before school (6-7 years ), after finishing 1st grade (7-8 years old), at the ages of 10, 12, 14-15, 16 and 17 years old.
Correct measurement of blood pressure is important not only to diagnose hypertension, but also to avoid its overdiagnosis. With a daily dynamic study of blood pressure, measurements should be taken at the same hours, preferably in the morning before meals. The height of the table should be such that the middle of the cuff placed on the shoulder is at the level of the child’s heart. Before determining blood pressure, the child should sit quietly on a chair with a straight back next to the table for at least 5 minutes. Blood pressure is measured on the right arm (in left-handers on the left), three times at 2-3-minute intervals.
To more accurately determine the level of blood pressure, the severity of hypertension and its prognosis, a method for assessing the daily blood pressure profile is used - daily blood pressure monitoring (ABPM). ABPM is indicated for significant fluctuations in blood pressure during one or more visits to the doctor, or if hypertension is suspected. When a disease is detected, treatment is prescribed.
The main goal of hypertension treatment is to achieve sustainable normalization of blood pressure, which reduces the risk of developing early cardiovascular diseases. For children and adolescents, this means achieving a target blood pressure level that is appropriate for age, gender and height.
Treatment of a child with hypertension can be non-drug and medicinal, complex and long-term. In children and adolescents, non-drug therapy is of enormous importance.
The main methods of non-drug therapy in childhood are:
lifestyle changes;
measures to reduce excess body weight;
physical activity;
change in diet and quality of food.
It is known that reducing the calorie content of food through the consumption of animal fats and easily digestible carbohydrates leads to a decrease in body weight, especially
in combination with an increase in physical activity carried out through dynamic loads - swimming, running, team sports. It is necessary to eliminate unfavorable psychological factors if it is possible to find out (conflicts in the family, school). Psychotherapeutic approaches to the treatment of children with hypertension should concern all family members.
The diet used for high blood pressure must meet the following requirements:
it is necessary to limit table salt to 3-7 grams per day;
reduce the consumption of easily digestible carbohydrates (sugar, jam, honey, sweets);
limit animal fats (at least 1/3 of the amount of fats should be vegetable fats);
exclude strong tea, coffee, cocoa, alcoholic drinks, spicy, salty snacks, canned food, spices, smoked foods, fatty meats, fish;
add vitamins A, B1, B2, B6, C, PP to food;
eat food 5-6 times a day;
include foods rich in potassium and magnesium in your diet: nuts, dried fruits, baked potatoes, pumpkin, zucchini, beans, beans, peas, cauliflower, broccoli, bananas, grapes, apricots, peaches, seafood, as well as cottage cheese, hard cheeses, oatmeal.
Drug therapy is prescribed only when all non-drug treatment methods have been used and there is no effect from them. But you should also know that there are conditions that are an absolute indication for the prescription of drug therapy in children with hypertension: secondary hypertension, target organ damage (left ventricular hypertrophy, retinopathy - non-inflammatory degenerative changes occurring in the retina, etc.).
It is necessary to consult a cardiologist if there is any deviation in blood pressure in children, and only a doctor will prescribe a set of examinations, give recommendations on the regimen, diet, determine non-drug or drug treatment and thereby prevent serious illnesses in the future.
Arterial hypertension in children
1. Limit salt consumption (taking into account the salt that is added to ready-made dishes). Salt retains water in the body, therefore, the volume of blood circulating through the vessels increases. This leads, in turn, to increased stress on the heart and kidneys. Also, a large amount of salt in the diet leads to edema.
2. Normalize excess weight . It is often the cause of arterial hypertension in children even of primary school age. Obese people are many times more likely to have high blood pressure compared to those who are of normal weight. With obesity, cholesterol is deposited on the walls of blood vessels, narrowing their lumen. This leads to increased blood pressure.
To reduce body weight and normalize lipid metabolism, diet No. 10 is recommended - for those who suffer from cardiovascular diseases.
3. Ensure that the child is physically active . Regular physical education, especially if it is not very active, may not be enough. Walk with your child more often. In the yard he can play active games with friends: football, volleyball, basketball, tennis, badminton. If parents have a habit of running in the mornings or evenings, it will be useful to take the child with them. Thus, he will be instilled with a culture of a healthy lifestyle.
But before increasing physical activity for a child, you should consult a pediatrician, check your blood pressure, and sometimes conduct a general examination of the body. For children who have health problems, a special complex of physical therapy may be suitable.
4. Help the teenager get rid of bad habits . Parents, setting a negative example for their children (starting from infancy), instill in them a passion for addictions. When buying alcohol with a child, remember that he understands everything even despite his very young age. And in a few years he will also reach for the bottle.
Therefore, parents must set the right example for their children so that they do not acquire bad habits and lead a healthy lifestyle. If your child already has negative habits, you can agree to stop them together. After all, support is a very important factor in changing your lifestyle. Talk to your children, communicate with them more often, then you won’t have to swear in an attempt to wean your child from smoking or alcohol.
Teenagers with bad habits have a 3 times higher chance of being diagnosed with arterial hypertension. And the longer a child’s smoking experience, the more difficult it is to quit. The disease progresses over time, and then just giving up the bad habit will not be enough. This is important to remember and explain to your child.
