We always thought that high blood pressure (BP) or hypertension was the disease of the adults, mainly elderly, didn't we? With a sedentary lifestyle, decreased physical activity and increasing stress seen in adolescents, and with a growing epidemic of obesity in adolescents, high blood pressure in adolescents is now an alarming health problem that should not be overlooked. A high BP in adolescents is correlates with increased chances of hypertension and cardiovascular diseases in adulthood.
In children and adolescents, high BP could be a result of underlying heart disease, kidney disease or an endocrine (hormonal) ailment. This is called secondary hypertension. More commonly, adolescents with primary or essential hypertension may have a high BP without any underlying systemic illness. These patients may have no symptoms and can be picked up ONLY if they are screened by checking their blood pressure during their annual health check-up visit. If family risk factors of high BP or cardiovascular diseases or high cholesterol levels is present, these adolescents will require BP checks at very visit. There are BP percentile charts for various age groups that can pick up hypertension in its early stage. Apart from family history, the current generation of adolescents also have life-style factors that can contribute to their high BP. Disordered sleep pattern, junk diet, obesity, smoking, alcohol intake and drug abuse are the risk factors.
As earlier mentioned, most adolescents are asymptomatic. But sometimes, they may present to the casualty with severe headache, vomit and altered mental status, if their BP suddenly shoots up.
Investigations may include targeted screening tests for comorbid conditions like hyperlipidemia, diabetes mellitus, hormonal issues and chronic kidney disease.
Initial treatment involves life-style modifications like a healthy diet, regular physical exercise to ensure weight loss and stress-relieving measures like yoga and meditation for about 3-6 months. Some patients will require anti-hypertensives. Long term follow-up is essential for all patients.
Thus, identification of adolescent hypertension in the adolescent age group is the key factor in the long term management of adult hypertension.
Dr. Rajiv Bhagwat (Sr Consultant - Cardiology)
Dr. Rajiv Bhagwat is the Senior Consultant, Heart Institute and one of the most renowned cardiologists of the city with an experience of over 31 years. He specialises in Complex Coronary Angioplasty, especially bifurcation or Y angioplasty.