Hypertension is estimated to affect more than 50 million Americans and is the leading causes of cardiovascular disease, end-stage renal disease, and cerebrovascular accidents. And although it is more common in adults, hypertension affects nearly 5 percent of the pediatric population. For High Blood Pressure Awareness Month, Dr. Robert Woroniecki, Division Chief of Pediatric Nephrology and Hypertension, Stony Brook Children's Hospital and Dr. Katarina Supe-Markovina, Director of the new Pediatric Hypertension Center, Stony Brook Children's Hospital, are shedding some light on a growing health problem among our country's youth.
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," said Dr. Woroniecki. "Conversely, sometimes chronic kidney disease leads to high blood pressure. Whatever the cause, the effects can dramatically influence a child's health."
And while children with hypertension do not carry the same immediate risk of heart attack or stroke like adults with hypertension face, high blood pressure can still cause changes in your child's body, putting them at risk for future complications, and this is why this condition should be taken seriously.
The best way to uncover hypertension, which is also known as the "silent killer" because it typically shows no overt symptoms, is through blood pressure readings. "Children who are overweight or obese should be checked regularly," said Dr. Supe-Markovina. "The same goes for children who fall into higher risk categories, such those with identified kidney problems, or born prematurely."
Normal numbers depend of three factors: gender, age and height. If a child falls above the 95th percentile, they are considered to have high blood pressure. Once a diagnosis is made, the best course of treatment 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 long-term 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.
Stony Brook Children's has the only pediatric nephrology service on Long Island that can manage the full spectrum of pediatric kidney diseases, including dialysis and kidney transplants. The Children's Hospital also has 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," said Dr. Woroniecki. "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 offers what we call the children's hospital difference," said Dr. Supe-Markovina. "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."
Cite This Page: