Pediatric Hypertension Treatment at Columbia

Family-Centered Care

High blood pressure is often shared by more than one member of a family. Columbia’s Hypertension Center is designed to provide care for the whole family. This might include genetic testing when we suspect an inherited condition, or diet and lifestyle changes that benefit all family members.

Our doctors include both pediatric and adult specialists. That means that our pediatric patients can move from child to adult care easily and seamlessly, with no interruption in treatments or needing new tests.

Our pediatric specialists will work with your family to understand the cause of your child’s high blood pressure and create a plan to treat it. Your child’s treatment plan will depend on two things:

• The cause of your child’s high blood pressure
• The severity of your child’s high blood pressure

Your child’s treatment plan may include:

• Ambulatory blood pressure monitoring
• Genetic testing
• Medication
• Lifestyle and diet changes

What to Expect From Your Appointment

Your child’s first appointment at the Hypertension Center will involve an evaluation by one of our pediatric nephrologists. Nephrologists specialize in issues with the kidneys, including those that might cause hypertension. The doctor will ask questions about your child’s general health and any family history of high blood pressure. A physical examination will include blood pressure measurement.

Our goal is to uncover the cause of your child’s hypertension. We may have your child undergo some tests, including:

• Urine sample, which can give us information about your child’s kidney function
• Blood test, which measures your child's blood sugar, kidney function, and blood cell counts
• Echocardiogram, which checks the blood flow through your child's heart
• Ultrasound, which allows us to look at your child's kidneys
• Genetic testing, if there is a family history of high blood pressure

Ambulatory Blood Pressure Monitoring

We may also provide you with a 24-hour ambulatory blood pressure monitor so that we can understand your child’s blood pressure over time. This is a small device that your child can wear on a belt, with a cuff that can be worn under a shirt. The monitor measures your child’s blood pressure automatically every 15 or 20 minutes during both waking hours and sleep.

At-home monitoring can also rule out “white coat hypertension”, which is high blood pressure that occurs in the doctor’s office—usually due to anxiety—but returns to normal at home.

Genetic Testing

High blood pressure can run in families.  We may recommend genetic testing. Genetic testing looks for genes specific to certain conditions that cause high blood pressure.

Lifestyle and Diet

A healthy diet and exercise will be part of your child’s treatment plan. We will work with you and your child to look at where realistic changes can be made—with an emphasis on changing habits for the whole family. This may involve:

• Healthier diet: preparing healthy foods such as whole grains, vegetables, and fish, and reducing sugar, fat, and salt
• Daily exercise: adding a daily exercise routine and reducing screen time
• Weight loss: reducing extra pounds to lower blood pressure

Medications

For children with severe hypertension, we may prescribe medication. In some cases, medication is a temporary solution until a condition has been treated or a child has lost weight. Medications might include:

• Angiotensin-converting enzyme (ACE) inhibitors, which relax the blood vessels, making it easier for your child's blood to flow.
• Angiotensin II receptor blockers, which relax blood vessels by blocking a natural chemical that narrows the blood vessels.
• Calcium channel blockers, which relax the muscles of your child's blood vessels and may slow his or her heart rate.
• Diuretics, which help the kidneys to remove sodium and water, reducing blood pressure.