People rarely think that children can have high blood pressure. But the reality is that hypertension is becoming a growing problem among children and teens. Here, Dr. Robert Woroniecki, Division Chief of Pediatric Nephrology and Hypertension, and Dr. Katarina Supe-Markovina, Director of the new Pediatric Hypertension Center at Stony Brook Children’s Hospital, discuss what every parent needs to know.
Why is high blood pressure a problem in children?
Hypertension, or higher than normal blood pressure, is an increasing problem in children because of the growing incidence of obesity and metabolic disorders. Hypertension puts a strain on the cardiovascular system, and makes children at risk for heart disease and chronic kidney disease later in life. Conversely, sometimes chronic kidney disease leads to high blood pressure. Whatever the cause, the effects can dramatically influence a child’s health.
What are the symptoms?
Hypertension has long been called the “silent killer” because it typically shows no overt symptoms. The best way to uncover it is through blood pressure readings. Children who are overweight or obese should be checked regularly. The same goes for children who fall into higher risk categories, such those with identified kidney problems, or born prematurely.
Where should we seek treatment?
The best way is to work with a multidisciplinary team of specialists who can accurately diagnose the problems, recommend the appropriate treatment — typically a combination of lifestyle changes and medication — help the child and family manage the disorder, and perform longterm care and follow-up. A pediatric nephrologist— a specialist in children’s kidney disorders — is often the best point person to handle pediatric hypertension. He or she may bring other specialists onto the team, including pediatric cardiologists, pediatric endocrinologists and nutritionists, but the nephrologist’s expertise in 24-hour ambulatory blood pressure monitoring and pharmacologic treatment is usually the driving force behind the care.
Where can I find a pediatric nephrologist?
Stony Brook Children’s has the only pediatric nephrology service in Suffolk and Nassau counties that can manage the full spectrum of pediatric kidney diseases, including dialysis and kidney transplants. We also have the region’s first Pediatric Hypertension Center. The Center takes a multidisciplinary approach that brings key pediatric specialists together under one roof so they can comprehensively address emerging or existing hypertension issues in children. In addition to family education, counseling, and lifestyle and medical management, the approach utilizes one of the key tools in diagnosing hypertension: ambulatory blood pressure monitoring. Similar to the Holter heart monitor, ambulatory blood pressure monitoring tracks blood pressure changes for 24 hours. The information obtained by the monitor can identify blood pressure patterns, pinpoint risks and help doctors to develop an individualized program that most accurately and comprehensively addresses each patient’s needs. Stony Brook Children’s also offers what we call the children’s hospital difference. This means that every clinician at the hospital is experienced and trained in working with children at every age and stage of development. And it means understanding how disease presents in children, how they respond to medications and how a kind word is just as important as the next round of medicine. It also means bringing the family onto the treatment team, finding innovative ways to relieve the stress of hospitalization, delivering “ouchless” medicine and ensuring continuity with school, friends and activities. It’s a different way to deliver peace of mind to families, better care to the child and better outcomes overall.
|One of the greatest risk factors for pediatric hypertension is obesity — which has doubled in children and tripled in adolescents in the past 30 years. Stony Brook Children's new Healthy Weight and Wellness Center proactively and compassionately addresses this concern. It offers children ages 5 to 18 a positive, evidence-based approach to achieve safe weight loss, maintain a healthy weight lifelong and reduce the long-term risks associated with obesity, including hypertension. Led by board-certified pediatrician Rosa Cataldo, DO, the team includes registered dietitians, psychologists, physical therapists and supporting pediatric specialists — all of whom take a highly individualized approach to each child.|
To learn more about Stony Brook's Children's, call (631) 444-KIDS (5437).
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