Children with High Blood Pressure: Will Concern Bring Care?

The American Academy of Pediatrics (AAP) has a rising concern about children with high blood pressure. So they have issued new guidelines that could lead to a million or more new diagnoses.

Rising in Parallel with Severe Childhood Obesity

The best estimates suggest that 3.5% of children in the U.S. have high blood pressure. That means 2.6 million children with high blood pressure. And that number is roughly twice as high as prior estimates, which ranged from one to two percent.

Coincidentally, the number of children with severe (class III) obesity has more than doubled since 2000.

In the new guidelines, AAP identifies childhood obesity as a key risk factor for high blood pressure. The guidelines call for blood pressure to be monitored in every child with overweight or obesity on every visit. The AAP estimates that three quarters of children with high blood pressure never receive the diagnosis.

Support for Healthy Lifestyle Seldom Offered

But here’s the rub. The first line of care for children with high blood pressure is lifestyle modification. Intensive behavioral care can make a difference in nutrition and fitness. But it’s not easy. Simply telling a family, “Go make some changes,” has little effect. As the USPSTF pointed out in new guidelines, intensive support programs are effective. Passing advice is not.

And right now, the systems are not in place to provide that intensive support. Health plans typically won’t pay for it. They’ll just pay for the drugs when empty words don’t work.

This has to change.

Click here for the new guidelines from AAP and here for more from U.S. News.

Mother with Children, painting by Gustav Klimt / WikiArt

Subscribe by email to follow the accumulating evidence and observations that shape our view of health, obesity, and policy.

August 5, 2017