1.3 million US teenagers have high blood pressure – but that rate is plummeting

More children are now considered to have high blood pressure – including about 1.3 million teenagers – and the lower threshold is a better predictor of who will get heart disease later in life, a new study suggests. 

When the American Academy of Pediatrics changed its blood pressure guidelines in 2017, the change designated an additional 795,000 teenagers (who saw the most significant increase as a result of the change ) as having high blood pressure. 

A similar change to adult guidelines sparked concern that patients would be over-medicated and suffer side effects from statins. 

But the new study, from the American Heart Association, suggests that a lower standard for high pediatric blood pressure does better predict heart disease, and could encourage better preventive measures. 

Since the threshold for high blood pressure in children and teens was brought down in 2017, an additional 795,000 teenagers are considered to have hypertenion. A new study found that nearly 20 percent of children with high blood pressure developed heart disease 

Up until the new guidelines were implemented, about 1.88 percent of ‘healthy’ children had high blood pressure, as did 14.7 percent of children with obesity. 

The researchers that led the charge to change the guidelines estimated that doctors overlooked high blood pressure in about 75 percent of cases. 

Although lowering the hypertension threshold may make it seem as though children’s health in the US is worse, scientists say that they’ve seen an encouraging decline in high blood pressure in children and teens – despite the change. 

By the new standards, about 7.7 percent of children had high blood pressure in 2001. 

By 2016, that rate had fallen to 4.2 percent. 

Remarkably, these declines happened despite raising rates of obesity, which doctors would expect to drive up hypertension, too. 

Experts think that better diagnosis of high blood pressure combined with earlier changes to lifestyle factors – like diet and exercise – as well as quicker uptake of medications have helped drive the positive trend. 

Even if they develop high blood pressure early on in life, most people won’t see the negative health consequences until adulthood. 

High blood pressure during childhood raises risks of stroke, heart attack, heart failure and kidney disease down the line. 

To see if the new guidelines provided a more accurate litmus test of health problems later, researchers at the American Heart Association assessed data on 3,940 people who first had their blood pressures taken as children and then were followed for 36 years. 

If they’d gone by the previous standards, just seven percent of the group would qualified as having high blood pressure. 

But by the new guidelines, 11 percent would meet the threshold. 

And of those that met the new mark for high blood pressure 19 percent would go on to develop enlarged hearts, a sign that the organ has been working to hard to pump  blood through constricted veins, and a major risk factor for heart attack. 

Under the old standard, pediatricians would have identified only 12 percent of people that would develop thick heart muscles as being at-risk during childhood. 

Knowing that these people were at higher risk of heart disease would signal to doctors that these kids need to be put on diet and exercise programs or medications (though not all of them would require drugs) early on to protect them from disease.

‘For most children with high blood pressure that is not caused by a separate medical condition or a medication, lifestyle changes are the cornerstone of treatment,’ said lead stud author, Dr Lydia Bazzano, of the Tulane School of Public Health. 

‘It’s important to maintain a normal weight, avoid excess salt, get regular physical activity and eat a healthy diet that is high in fruit, vegetables, legumes, nuts, whole grains, lean protein and limited in salt, added sugars, saturated – and trans- fats to reduce blood pressure.’ 

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