New Blood Pressure Guidelines for Children

Hypertension in young children is SERIOUS. All children should have a blood pressure screening. As this article pointed out, 30-40 % can be “white coat” syndrome for which there is no treatment other than some monitoring not occurring in the doctor’s office. The rest needs treatment which can be as low tech as diet improvement, turning off the TV, computer, and video games. For the small percentage who do have pathology unfortunately it often involves aggressive treatment. Otherwise the outcome is loss of quality of life and death at a very early age. As a registered nurse working ER I always took a screening BP on my pediatric patients. I hate to tell you the number of patients I saw with elevated BP coinciding with obesity and sedentary life style.. it is NEVER too early to bring this to parents attention.

Wonderful. Now we can medicate 50 million American children. For life. Think of the profits! Next up: 'high' BP in the unborn, the not yet conceived, the dead...

That American Academy of Pediatrics report gives only grade C evidence and "moderate" strength recommendation to checking blood pressure annually in children over 3 years of age. In that case, is it really standard or recommended to do so? What about the risks of misdiagnosis and unnecessary treatment?

Correct diagnosis of hypertension and children seems like it’s an ongoing process and probably a struggle

Based on the children I see here in the states, the first, logical step would be to not have 50 pound five-year-olds.

Public schools check children's height, weight, eye sight and hearing every year. They should also check all children's blood pressure using an automatic blood pressure monitor and the new blood pressure chart for children.

God help the young if this mindset, that children have to be tested repeatedly, and treated, presumably with expensive drugs, for a condition that may be harmless, prevails. Could there be a connection between diet, including sweets and refined flour for example, and "high blood pressure"? We report. You decide.

Not all high blood pressure is from too much sodium intake. When I was first diagnosed with high BP I was told to start trying to control it with diet, primarily lowering my sodium intake. I did. Next visit I was told BP even higher, and although I had said I had substantially lowered my sodium intake, the doctor said lower it more. This repeated several times until I was consuming less than 400 mg sodium daily, all the while my BP went up. By this time is was in constant pain, escalating rapidly when I drank milk or orange juice, or some other high potassium food. I eventually found I had some relief when I increased my water intake. My doctor said fine, drink as much as you want - which soon turned out to be 3 gallons (yes gallons) per day. My doctor said make 1 liter of the intake a 'sports drink' for electrolytes. I chose Gatorade, which I distributed throughout the day. I eventually ended up at Mayo, where the same sodium cutting advice continued. One day I drank the liter of Gatorade in one go. Big surprise, my water consumption plunged, my BP dropped into proper range - and, after reading that what I had consumed had much more sodium than potassium, I got suspicious about the sodium lowering advice. I tried taking 300 mg sodium in glass of water, and found the same good result, but I could not get Mayo to observe the effect, as they were convinced I could only do myself harm. Lesson: if your blood potassium is always high, and sodium always low, be suspicious.

First things first, we need to make sure the blood pressure readings are being done correctly. Children can be very mobile, blood pressure cuffs are not always placed correctly, sizes are not always appropriate. Sometimes the automatic blood pressure machine needs to be calibrated, etc., etc.

What are the risks of possibly overtreating children with slightly high blood pressure for the rest of their lives?

Reading this line from the article, "Matthew takes pressure-lowering medication and adheres closely to a low-sodium diet loaded with fresh fruits and vegetables and no soft drinks.", I thought that perhaps NYT's "health" reporter Jane E. Brody actually learned something from the drubbing she took in the Comments section to her last article, Good Vegan, Bad Vegan (October 2, 2017). I can only hope there's a learning curve at work here. Time and further reporting will tell.

As someone who has had hypertension since I was a young teenager (with significant hereditary factors on both sides), I think it is great that the medical community is taking pediatric hypertension more seriously, because when I was diagnosed with it back in the '80s, the doctors treated me like a bit of a freak. Keep in mind that diet and exercise are often not enough to fix this. I was a varsity athlete in college, training 3-4 hours a day 6 days per week, and grew up in a household that used little salt due to my parents' hypertension, and still found that only medication could control it. I think that the nurse who convinced me to start taking my mediation regularly, when I was 22, probably added 10 years to my life. The only time that my blood pressure stayed in the normal range without medication, ironically, was when I was pregnant. Go figure. PS. Now I am trying to keep an eye on my 6-year-old daughter's blood pressure, and doctors are so blase about checking it that I am convinced they do not know what the numbers mean when they look at the machine. They just glance at them and say that it is fine when I now know that it is too complicated to properly understand at a glance. I will be printing off those tables and bringing them with me to the doctor from now on.

"To prevent this exam from being overlooked, Dr. Kaelber suggested that parents gently nudge the practitioner by asking, 'By the way, how is my child's blood pressure doing?'" How about a simple, direct question like, "Aren't you going to check the boy's blood pressure?" Seriously, think about Dr. Kaelber's suggestion in a different context. Would you gently nudge a practitioner with, "By the way, how are all the bacteria on your unwashed hands doing?" Here's my suggestion for parents: If you have to nudge your child's physician, gently or not, to do his job, it's time to find a new physician.

thank you. i did not realize children should be monitored for blood pressure results.

How about adding the BP chart to this article please