High blood pressure can start young

Doctors advise that children 3 years and older should be tested regularly

Blood pressure tests should be included as a regular physical checkup item for all children older than 3, as hypertension continues to rise among the very young and adolescents in China, pediatricians say.

Hypertension in minors is usually hard to detect, as 90 percent of young patients don't feel any discomfort or show any clinical symptoms, said Mi Jie, a pediatrics professor at the Capital Institute of Pediatrics, who is a leading expert on hypertension among young children and adolescents in the country.

"In many cases, high blood pressure in juveniles is not detected until they undergo a thorough physical examination upon graduating from senior middle school, or if they suffer serious headaches," she said on Friday at the fourth World Hypertension Congress, which opened in Shanghai on Thursday.

Zhao Di, director of the department of cardiology at Beijing Children's Hospital of Capital Medical University, said it was previously thought in medical circles that minors usually suffer from secondary hypertension. But research over the past 15 years found children suffering essential hypertension.

"In fact, the number of children suffering essential hypertension is higher than those suffering secondary hypertension, which overthrew our past understanding," he said.

The latest data from the China Health and Nutrition Survey show that the incidence of hypertension in juveniles between 6 and 17 years of age was 13.8 percent in 2009, up from 6.9 percent in 1993, and the blood pressure of children of all ages is rising in both genders.

Mi suggested that Chinese students should undergo blood pressure tests four times - at age 6, 10, 14 and 17. "Obese children and those whose parents suffer from hypertension should take the test once a year," she said.

The latest figures, from 2015, showed that 25.2 percent of Chinese adults had high blood pressure.

Pediatricians say that around 10 percent children and adolescents with hypertension can experience changes in their hearts, blood vessels or kidneys - decreased arterial elasticity, for example, and a decline in kidney function.

"In addition, around 40 percent of such children and adolescents will continue to suffer from hypertension into adulthood if there is no intervention," Mi said, adding that the incidence of hypertension in Chinese children and adolescents is not higher than their Western counterparts.

Obesity is one culprit in high blood pressure. Mi said that for minors deemed obese, according to their body mass index, or BMI, the likelihood of hypertension is three times that of their counterparts of normal weight.

A family history of hypertension, excessive salt intake, insufficient sleep and lack of exercise are also associated with high blood pressure among children and adolescents, she said.

Doctors recommend nondrug therapy for minors who have high blood pressure.

"These children and adolescents must spend more time in aerobic exercise and spend enough time sleeping, control salt intake and avoid constant stress. Weight control is vital," said Sun Jinghui, director of the pediatric cardiology department at the First Bethune Hospital of Jilin University.

"If lifestyle intervention doesn't prove effective after six months, or if the child's blood pressure begins to rise quickly, we'll resort to medicines," he said.

zhouwenting@chinadaily.com.cn

(China Daily 09/23/2017 page4)