My daughter is 4 years old. On the balance sheet of the four-year-old, it turned out that his blood pressure was too high 110/90. I would like to know what is the correct pressure and what may mean such increased?
Hello. Measurement of blood pressure in a small child is a difficult issue, and the issue of standards cannot be commented on by quoting a single value. This is due to the fact that children develop at different rates and the concept of the norm at this age is quite broad. The so-called percentile grids. Data falling between the 3rd and 97th percentiles are considered norms. The grid allows you to assess, among other things, height, weight, head circumference - in the pediatrician's office, you may have seen curves placed on the grid, thanks to which you can read the percentile of a given parameter. For some time now, we have also had a percentile grid for pressure values in young children. They were developed on the basis of pressure measurements in young children. In the literature it is believed that if the pressure in a child exceeds the 90th percentile, there is an increased risk of developing hypertension in adulthood. For a 4-year-old girl, the 90th percentile pressure values are 111/68. So in the case of a baby girl, the systolic blood pressure is slightly below the 90th percentile, while the diastolic blood pressure is above the 90th percentile. It should be noted here that the measurement of diastolic pressure (contrary to appearances, which may be derived from the observation of the measurement itself) is a rather complicated issue and there are many considerations on this subject in the specialist literature. When we test the pressure, we hear tones in the handset having different volumes. There are 5 phases of these tones. Phase IV is to lower the tones, and Phase V is the complete disappearance of these tones. Some experts consider phase IV to correspond to diastolic pressure, others to phase V, i.e. complete disappearance of tones. Since the tones between phase IV and V are very soft, it is sometimes difficult to accurately assess whether phase V is taking place - for example, when there is noise during the examination, or when the baby is crying. Accurate assessment of tones is possible when a mercury apparatus is used for the measurement. When using an electronic device for measurement, another situation takes place - the diastolic pressure value is then automatically calculated by the device based on the formula. Not all patterns are availablesufficiently accurate and not always adequately reflecting what is taking place in the organism of the tested person. A reliable pressure measuring device should be validated by an appropriate scientific committee. Therefore, in the case of a baby girl, blood pressure measurements should be continued - it is important to use appropriate measuring equipment and due diligence during the test. Not every child who had high blood pressure during the checkup as a child must develop high blood pressure in adulthood. The development of hypertension is favored by the coexistence of overweight and a diet rich in sodium ion. You should develop he althy eating habits in your daughter, avoiding s alty snacks such as - s alted popcorn, crisps, crackers, s alty sticks. If a child has high blood pressure and the family has high blood pressure in their parents or grandparents, this also increases the risk of developing high blood pressure in adulthood. Adolescence is an important period in keeping up with the child's blood pressure, as familial hypertension often becomes apparent at this time. Regards, Krystyna Knypl, MD, PhD
Remember that our expert's answer is informative and will not replace a visit to the doctor.
Krystyna KnyplInternist, hypertensiologist, editor-in-chief of "Gazeta dla Lekarzy".
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