How to manage hypertension in children

Hypertension is often thought the disease of adults particularly the elderly, but experts have revealed that children too now suffer from the disease.

A consultant and Head, Paediatric Cardiology an Infectious Diseases Unit, Department of Pediatrics, Lagos University Teaching Hospital (LUTH), Prof Christy Okoromah revealed that hypertension could affect a new born baby, especially premature and low birth weight babies (less than 2.5kg).

Speaking during this year’s World Hypertension Day organised by Nestle in Lagos recently, Okoromah said aside newborns, children of all age range, up to adolescent (18 years) years could be affected by hypertension.

She said that three to five percent of Nigerian children have hypertension, adding that this is higher than the rate for autism and paediatric HIV/AIDS.

While explaining that congenital adrenal hyperplasia could cause hypertension in newborns, she said that, renal diseases, alcohol, obesity, sedentary lifestyle, medications/drug intake and lots of other factors are responsible for high blood pressure in children.

The pediatric cardiologist enumerated some of the medications that causes hypertension in children as; paracetamol, steroids, dietary supplements, immunosuppresant, caffeine, and nasal drugs among others.

To prevent the disease, the expert said that, the weight and lifestyle of children should be properly given attention. She said parents should encourage their children to regularly exercise.

She discouraged children from sedentary living like watching the television and playing video games all day, but should rather be active like participating in outdoor games.

Smoking and consumption of alcohol, she said, would not help a child or adolescent prevent the disease, noting that some adolescents are passive smokers due to the environment they live, while others smoke and consume alcohol.

In his view, the Lagos State Chairman of the Nutrition Society of Nigeria, Dr Tosin Adu said the solution for both the prevention and management of paediatric hypertension is in what they consume.

“Paediatric hypertension occurs in some cases because a lot of the food and drinks we give to our children are not the right ones. Fizzy drinks is doing more harm than good. The more junk foods we take, the less nutritious foods children consume and it increases their weight. There is so much correlation between obesity, overweight and hypertension.

“We have seen a lot of children now who are overweight. When your children are looking chubby and you assume they are healthy, it’s not true. Their weight end up putting a lot of pressure on their hearts,” he said.

He said children should eat lots of fruits and vegetables and it should be presented in a way that would make them desire it. “Eating more local diets will help a great deal than pizza, meat pie, doughnut and such foods. Fast food is a no-no,” he said.

Just as adults are expected to take medications to manage their blood pressure, Professor Okoromah said children too need to take medications.

“There are drugs for paediatric hypertension too, though they are similar with that of the adults but the doses are different.”

 As important as the drugs are, she said that not all children may take it, especially if the underlined disease causing the hypertension (such as problem with the thyroid and other organs in the body) is addressed, the hypertension will be controlled and the need for a drug may not be necessary.

Okoromah noted that lots of paediatric hypertension cases that were not well managed when the children were young, end up becoming complicated hypertension cases when such children grow into adulthood.

She urged government to provide the appropriate cuff size for each age grade, provide a local national database on blood pressure in children, educate the stakeholders to know how to properly diagnose and treat the condition appropriately.

She further encouraged all hospitals and medical centres to be at par with others in the world by following the iioiodine salnternational recommendations which states that every child between three years and above should have their blood routinely checked during every hospital visit.

A professor of medicine and consultant cardiologist in LUTH, Prof Amam Mbakwe discouraged the consumption of too much salt in both children and adults saying it poses a great health risk and increases hypertension.

She said it is better to have low salt in our food than too much of it.

Be it iodised salt, sea salt or any other type, we need to reduce the quantity of salt in our food. Salt is not only in our cooked foods, it’s also present in other things we consume such as bread, biscuits, etc.

“We should look at the salt content of what we buy.Salt shakers should be banned from our table if possible. Some people will not even taste the food before shaking salt,” she said.

On her part, a senior lecturer in the nutrition and dietetics unit, College of Medcine, University of Calabar, Dr Chika Ndiokwelu gave the following advice on how to live healthy with or without hypertension:

“Increase the intake of fruits and vegetables, reduce the amount of oil you use in cooking, avoid fats from animals, trim up the saturated fats (bad fats), eat mackerel as it is the best type of fish, eat fish three times a week.

“Exercise, walk, take the stairs sometimes and not the lift everytime, dance, do some gardening, all these will reduce your stress,” Ndiokwelu said.