Hypertension: treatment

Does my child need treatment for hypertension?

If your child has hypertension, they will need to reduce and/or control their blood pressure. There are different ways to do this.

For some children, hypertension can be controlled with a healthy diet and lifestyle, as well as medicines, over a period of time.
For other children, hypertension is caused by an underlying condition that needs to be treated.

Your child’s doctor will recommend the treatments that are right for your child. This may include prescribing one or more medicines. If you have any questions or concerns, speak with your child’s doctor or nurse. Your views about treatment will be considered.

It is important that your child follows the treatment plan agreed with your doctor. If their blood pressure is not controlled, they are at higher risk of stroke, heart attack and heart failure. They are also at higher risk of damaging their kidneys.

Questions to ask the doctor or nurse

Do I need to make any changes to what my child eats and drinks? How can I get more information and support about this? How can I get more information and support about this?
Can my child take part in all types of sports and activities?
How often do I need to measure my child’s blood pressure at home?
What is the acceptable range for my child’s blood pressure?
What do I do if the blood pressure readings are too high?
When do I need to call or come back to my child’s doctor or the hospital?

Living with hypertension: eating and drinking

Your child may need to change what they eat and drink. Speak to the doctor or nurse for more information. Below are some tips you can follow as a family to keep your child’s blood pressure healthy.

Eat less salt

Reducing the amount of salt you eat can help to control blood pressure. Avoid eating or drinking lots of salted nuts, crisps, crackers, soft drinks, fast food meals, takeaways and processed foods (meals that are pre-prepared, including soups) – these often have more salt than we think. Do not add extra salt to meals that you cook or at the dining table.

Eat a healthy diet

Eat lots of fresh fruits and vegetables. Swap white bread, rice and pasta for whole-wheat varieties. Avoid food and drinks with lots of added sugar (including sweets, sugary cereals, high-sugar squash and fizzy drinks or sodas). Limit caffeine (which is found in coke drinks, tea and coffee).

Drinks

Your doctor will advise you on how much fluid (such as water) your child should drink.

If your child has a kidney condition

If your child has a kidney condition, he or she may need to make further changes to their diet. This is because your child’s kidneys need special care. A paediatric dietitian may be able to provide further support.

Living with hypertension: sports and activities

Some children with hypertension need to limit the amount of exercise they do when their blood pressure is too high or if they have some types of heart conditions. Once their blood pressure is controlled, most children can take part in the same sports and activities as others. Most children should be physically active for at least 30 minutes a day. Speak to your doctor or nurse about which sports and activities your child can take part in. Make sure your child gets plenty of sleep.

Living with hypertension: medicines

Your child’s doctor may prescribe medicine to control or reduce their blood pressure, in order to treat hypertension. A few children with hypertension need to take medicine to control blood pressure for the rest of their life.

Never stop the medicine without telling your doctor or nurse.

Medicines for Children – information about giving medicines to children

Medicines used to treat hypertension in children

There are many medicines used to treat hypertension in children. Your doctor will prescribe the medicine that they think is best for your child.

angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) – common medicines include captopril, enalapril, lisinopril, losartan, valsartan
calcium-channel blockers – including amlodipine, nicardipine, nifedipine, nimodipine
Beta-blockers – including atenolol, carvedilol, esmolol, labetalol, metoprolol, propranolol, sotalol
alpha-blockers - including doxazosin, phenoxybenzamine, prazosin
vasodilators – including hydralazine, methyldopa, minoxidil
diuretics - including amiloride, bendroflumethiazide, bumetanide, chlorothiazide, chlortalidone, furosemide, metolazone, spironolactone

General information about medicines for hypertension

It is important that your child continues taking the prescribed medicine. If you are not sure a medicine is working or think it is no longer needed, contact your doctor but continue to give the medicine as usual in the meantime. Do not give extra doses as you may do harm.
Contact your doctor straight away if your child is vomiting (being sick) and cannot take their medicine for more than 24 hours.
Check with your doctor or pharmacist before giving any other medicines to your child. This includes paracetamol, ibuprofen, herbal or complementary medicines.
Only give the medicine to your child. Never give it to anyone else, even if they have high blood pressure, as this could do harm.
If you think someone else may have taken the medicine by accident, contact your doctor straight away.

Side-effects

Sometimes medicines have other effects that we don’t want – side-effects. Your child’s doctors will check the side-effects and if the medicine is working. They may need to change the medicine so that it is right for your child.

Let your doctor know if your child has any of the following side-effects:

feeling tired or drowsy
a dry cough
dizziness, faintness or light-headedness
a skin rash
headaches
poor sleeping.

Other side-effects to watch out for:

With some medicines, your child may grow more hair around their body. If you are concerned, speak to your doctor about it at your next visit.
If your child takes some blood pressure medicines for a long time (several months), their gums may become tender or swollen, and may bleed when they brush their teeth. They will return to normal when the treatment is stopped. Brushing their teeth with a soft toothbrush and regular flossing will help. If you are concerned, contact your doctor or dentist.
Your child’s ankles may swell (get bigger).

Hypertension: long-term effects

Hypertension can be a serious condition if it is not well controlled. Hypertension increases the risk of other diseases, especially if it continues into adulthood. These include stroke, heart attack, heart failure and kidney disease.

Your child’s blood pressure will need to be carefully controlled to reduce the risk of other diseases. If your child has an underlying condition, they will also need treatment for that.

Children with hypertension can generally do all of the things that other children their age do, as long as their blood pressure is well controlled.

Follow up appointments

Your child may need to go back to your doctor or to the hospital to have their blood pressure checked, or for further tests or treatment.

Your child may need to see a paediatrician (children’s doctor) in your local hospital, or to see a specialist paediatrician. Your doctor will let you know what to expect.

Contact your doctor straight away if your child is vomiting (being sick) and cannot take his or her medicine for more than 24 hours (1 day).

Monitoring blood pressure

Your doctor or nurse will let you know when your child’s blood pressure needs to be measured. He or she will know normal ranges of blood pressure for children who are the same age, sex and height as your child, and will let you know what your child’s readings mean. In children, the systolic blood pressure (top number) is normally more important. For example, the targets for the systolic numbers for children are as follows (mmHG means millimetres per mercury, which is how blood pressure readings are recorded):

4 years old: 95 mmHG
8 years old: 100 mmHG
12 years old: 110 mmHG
16 years old: 115 mmG

Your doctor or nurse may ask you to check your child's blood pressure at home or over 24 hours.

Other procedures

If your child is having another procedure at hospital, tell the doctor there that they have hypertension, and give a list of the medicines they are taking. They may need to stop one or more medicines.

Impact on your child