Lack of physical activity, high adherence to diets high in salt and sugar and being overweight are related to high blood pressure in 9 out of 10 cases seen in children and adolescents, according to a study published by experts from the European Society of Cardiology, in the European Heart Journal.
The document, released at the end of July, presents data on children and young people between the ages of 6 and 16 and recommends changes in habits so that families stay healthy together. According to the authors, parents are important and fundamental agents for this change to occur.
The identification of arterial hypertension in young people is complex and involves parameters and patterns that differ according to the doctor. Because of this, cardiology experts reviewed the literature and current evidence to compile and try to get closer to a consensus.
“There were guidelines from several medical societies, but this matter had never been standardized. So, there were different understandings. This document will facilitate the diagnosis and treatment of children and adolescents in a more standardized way”, explains Gustavo Foronda, pediatric cardiologist at the Hospital Israeli Albert Einstein.
In the past, according to the expert, cardiovascular risk factors in childhood were not highly valued by health professionals. In this way, the person would only start some treatment in adulthood, probably, and when some comorbidity was already installed.
“This concept has changed completely over the years. We know that each and every heart disease in adults starts in the pediatric age group: hypercholesterolemia, hypertension, obesity. All this leads to a greater cardiovascular risk in adults if you don’t treat it childhood”, warns Foronda.
It is estimated that 2% of children with normal weight are hypertensive, against 5% of overweight children, and among those with obesity, the rate reaches 15%. The consensus refers to childhood hypertension and obesity as “treacherous brothers” that gradually become a serious health risk.
In addition, the article also states that hypertension and obesity in children are becoming increasingly common (especially abdominal obesity, the most dangerous for heart health).
“Today, any child or teenager goes to the school canteen and buys what they want. This obviously allows them to choose a more palatable food, which is fast food. obesity levels are exploding. Consequently, blood pressure levels too”, warns the cardiologist.
According to experts, early diagnosis of childhood hypertension is essential so that it can be controlled only with lifestyle changes, without the need for medication. As it is an asymptomatic and silent problem, it is recommended that the child’s blood pressure be evaluated at least once a year in consultation with the pediatrician.
The ideal blood pressure levels are not like in adults – there are levels established for each age group, according to the child’s body surface and arm circumference. To get the correct value, you need to measure it properly (it’s no use going to the pharmacy on the corner of your house, for example).
“There is a table to determine the appropriate pressure levels for each moment of life. Ideally, the clinician or pediatrician should measure the child’s pressure in routine consultations. We know that this is not a regular practice, but increasingly they are becoming aware of this need”, says Foronda.
According to the cardiologist, the American Academy of Pediatrics recommends that these measures begin to be evaluated in all children from the age of 3.
Change in lifestyle
If there is a suspicion that the lifestyle is the major cause of hypertension, the first guideline is to change lifestyle habits and this involves not only the child, but the style of the entire family. This is because high blood pressure and obesity often coexist in the same family.
“It’s no use trying to change the habits of a child in isolation. In general, when you have a sedentary, obese or hypertensive child, this is usually a reflection of the family. If you don’t treat the family as a whole, the chance of the child adhering to the changes is very low”, says Foronda.
Dietary recommendations included in the study published by the European Society of Cardiology include: emphasizing a diet rich in fresh vegetables, fruits and fiber-rich foods; limit salt intake; and avoid the consumption of sugar, sugary drinks and saturated fat.
In addition, scientists highlight the importance of performing at least one hour of moderate to intense physical activity a day (such as cycling, swimming, or running) and not spending more than hard hours in sedentary activities (such as watching TV, playing games) video game or stay on the tablet and cell phone).
The document also guides that realistic goals should be established for weight loss, diet and physical activity – always focusing efforts on the aspects that need more improvement. The consensus of physicians also suggests that advances in the evolution of weight loss, improvement in eating habits and physical activity should be recorded to monitor progress.
“The great difficulty in treating childhood hypertension is that we need to treat obesity and overweight together. Hypertension is a silent disease that does not cause any apparent harm. It is necessary to change the lifestyle of an entire family for the treatment. It takes time and we often don’t have a quick answer.”