Does Hypertension Lead to Growth Retardation in Children?

Hipertansiyon Çocuklarda Büyüme Geriliğine Yol Açar mı?

Hypertension, which is thought to be an adult problem, is also being detected in children at increasing rates today. Pointing out that primary hypertension can develop without any symptoms in childhood as well as in adults, Pediatric Nephrologist Prof. Dr. Ruhan Düşünsel emphasized that especially overweight and obese children are at high risk for hypertension. On the other hand, they warned that in addition to general symptoms such as headache, visual impairment, and low school achievement in children with symptomatic hypertension, secondary hypertension may also lead to growth retardation.

Research in recent years shows that children have about 3-5 percent hypertension. This problem, which is extremely important for adults, is different from adults in childhood. Pediatric Nephrology Specialist Prof. Dr. Ruhan Düşünsel said that about 90 percent of hypertension cases in adults have no cause. However, risk factors such as being overweight, smoking, being malnourished (salty, fatty, high-calorie), and being prone to being a family member are mentioned. This group is called primary hypertension. The remaining 10 percent of hypertension cases are also called secondary hypertension due to an accompanying disease. By contrast, 15 percent of children have primary hypertension, and the remaining 85 percent have secondary hypertension.

Beware of These Symptoms!

Indicating that hypertension in children is not noticed by families, Prof. Dr. Ruhan Düşünsel, therefore, said that if there are symptoms such as "constant headache, dizziness, fainting, nosebleed, snoring in sleep and blurred vision", the physician should be consulted.

Stress and Test Anxiety are also Causes of Hypertension

Yeditepe University Kozyatağı Hospital Pediatric Nephrology Specialist Prof. Dr. Ruhan Düşünsel pointed out that many other factors, from poor nutrition and sedentary lifestyle to stress, may pose a risk for hypertension and said, "Exam stress causes an increase in blood ranks in emotional states such as other stresses, fear, excitement and joy in daily life. Prof. Dr. Ruhan Düşünsel said that high school and university exams are at risk for hypertension due to long periods at the desk and junk food snacks in exemplary children.

What Should Be the Blood Pressure Value for Children?

Indicating that there has been an increase in the frequency of primary hypertension with the increase in obesity in recent years, Prof. Dr. Ruhan Düşünsel provided the following information for the hypertension values defined for children:

"It is not possible to say a single value as the limit of hypertension in childhood adults. However, percentile tables prepared according to age, gender, and height are used in the definition of hypertension, as are standard curves and tables used in height and weight follow-up of children and adolescents between the ages of 0-18. Accordingly, values below the 90th percentile are called normal, values between the 90th and 95th percentile are called high blood pressure or prehypertension, and values above the 95th percentile are called hypertension."

The Vicious Cycle of Sedentary Life, Obesity, and Hypertension

Stating that the incidence of obesity has doubled all over the world in the last 30-40 years, Prof. Dr. Ruhan Düşünsel added looking at the world data that the obesity rate was 0.7 percent in girls and 0.9 percent in boys in 1975, but by 2016, these rates increased to 5.6 percent in girls and 7.8 percent in boys. "These numbers may seem low, but it's important to note that these numbers account for a significant portion of what we call obesity. Therefore, these rates increase up to 20-30 percent when overweight is added to them," said Prof. Dr. Ruhan Düşünsel, adding that recent studies in our country have found that obesity and being overweight in school-age children are seen at similar rates.

Treatment Starts with a Lifestyle Change

Obesity and hypertension, which start in childhood, can lead to bigger problems at later ages. It causes the development of many diseases such as cardiovascular diseases, insulin resistance, type 2 diabetes, fatty liver disease, psychological and orthopedic problems, and sleep disorders. Yeditepe University Hospital Pediatric Nephrology Specialist Prof. Dr. Ruhan Düşünsel reminded us that the first cause of loss of life today is a heart attack, cerebral hemorrhage, and stroke, and said that the primary reason behind this was hypertension. "For this reason, we as physicians recommend and care about losing weight first. We call it non-pharmacologic therapy, or lifestyle regulation. Losing weight is not easy, but success is achieved through regular exercise and diet. At this stage, families should set an example for their children and children should gain regular activity and eating habits at an early age for a healthy life.

"When families apply to the physician with the suspicion of hypertension in their children, firstly the height and weight of the child are measured, and the body mass index is calculated. Abdominal circumference and height ratio are required for abdominal obesity. Children with a body mass index below 85 percent are considered normal. Between 85 and 95 percent are considered overweight and over 95 percent are considered obese. Emphasizing that obesity can lead to hypertension and cardiovascular diseases, Prof. Dr. Ruhan Düşünsel added that therefore, excess weight should be given immediately.