High Blood Pressure in Children

We usually think of high blood pressure, or hypertension, as a problem that affects adults. But in fact, this condition can be present at all ages, even in infancy. About five of every 100 children have higher than normal blood pressure, although less than one in 100 has medically significant hypertension.

The term blood pressure actually refers to two separate measurements: systolic blood pressure is the highest pressure reached in the arteries as the heart pumps blood out for circulation through the body; and diastolic blood pressure is the much lower pressure that occurs in the arteries when the heart relaxes to take blood in between beats. If either or both of these measurements is above the range found in healthy individuals of similar age and sex, it's called hypertension.

Hypertension is more common among individuals of color than whites. It also seems to be more prevalent in some parts of the world; for example, it's very rare among Alaskan Eskimos but affects as many as 40 of every 100 adults in northern Japan. In many cases hypertension seems to develop with age. As a result, your child may show no signs of high blood pressure as an infant but may develop the condition as she grows.

Effects of High Blood Pressure

In most instances of high blood pressure, no known cause can be identified. However, when hypertension becomes severe in children, it's usually a symptom of another serious problem, such as kidney disease or abnormalities of the heart, or the nervous or endocrine (gland) system.

Fortunately, high blood pressure alone rarely causes serious problems in children and can be controlled through dietary changes, medication or a combination of the two. However, if hypertension is allowed to continue or become worse over many years, the prolonged extra pressure can lead to heart failure. In addition, the stress on blood vessels in the brain can cause them to burst, producing a stroke. Also, long-term hypertension causes changes in blood vessel walls that may result in damage to the kidneys, eyes and other organs. For these reasons it's important to follow the pediatrician's advice carefully if your child is diagnosed as having high blood pressure.

Symptoms of High Blood Pressure

In most routine physical examinations, your child's blood pressure will be measured. This is how hypertension is usually discovered. Most often, this condition causes no noticeable discomfort, but any of the following may indicate high blood pressure:

• Headache
• Dizziness
• Shortness of breath
• Visual disturbances
• Fatigue

High Blood Pressure Tests

If your child is found to have high blood pressure, your pediatrician will order tests to see if there is an underlying medical problem causing it. These tests include studies of the urine and blood. Sometimes special X-rays are used to examine the blood supply to the kidneys. If, as in most cases, no causative medical problem can be found, the diagnosis of essential hypertension will be made.

Article Source: Medical Health Care Information

Overweight kids have greater risk of foot problems

Kids who carry excess pounds may be doing permanent damage to their feet, a group of foot and ankle surgeons warns.

"When there is an increased amount of weight and stress being placed on the foot, that can cause some significant changes in foot structure," Dr. Darryl Haycock, a foot and ankle surgeon in private practice in Lima, Ohio, told Reuters Health.

Children's feet aren't fully developed until the age of 14 or 15 for girls, 15 to 17 for boys, meaning their foot bones are "easily moldable," Haycock added.

As few as 15 to 20 extra pounds can contribute to flattening of the arches and inflammation of the growth plate in the heel, according to Haycock, who says he used to only see this type of foot pain in very active children, but is seeing it increasingly in overweight kids.

It's difficult to determine whether children are obese because they have foot problems in the first place, which make it painful for them to be active, or whether the obesity is causing the changes in foot structure, Haycock added.

"It's the proverbial chicken and the egg thing," he said. Complicating matters is the fact that many children are born with foot deformities that can reduce their activity levels, such as flat feet or hammer toes.

But it is clear that foot problems in obese kids can cause a vicious cycle, with the foot pain making it more difficult for them to be active, which makes it more difficult to trim down, Haycock and his colleagues point out.

Treatment of foot problems generally begins with conservative therapies such as custom-made shoe inserts, known as orthotics, and physical therapy. If such approaches don't work, surgery to correct the problem may be recommended.

Article Source: Medical Health Care Information

Braces improve smiles, not self-esteem

Braces may straighten crooked teeth, but they're unlikely to alter your self-esteem and satisfaction with life, according to researchers.

In a 20-year study that followed more than 300 British children into adulthood, researchers found that those who'd had their imperfect smiles corrected with braces were not happier or psychologically healthier than their peers who went without braces.

Self-esteem in adulthood, the study found, was far more dependent on quality of life and similar factors than on orthodontics.

"This runs contrary to the widespread belief among dentists that orthodontic treatment improves psychological well-being, for which there is very little evidence," study co-author Dr. William C. Shaw, an orthodontist at the University Dental Hospital of Manchester, England, said in a statement.

He and his colleagues report their findings in the British Journal of Health Psychology.

In 1981, the study enrolled 1,018 children between 11 and 12 years old who had their dental health and psychological well-being evaluated. The children's teeth were examined, but the researchers made no recommendations on whether they should get braces.

Twenty years later, the researchers were able to re-evaluate 337 of the original participants.

They found that the subjects who needed braces as children, and eventually got them, did not appear to be enjoying greater mental health. There was also no evidence that children who failed to have their teeth fixed suffered any long-term psychological damage.

When it came to self-esteem, Shaw's team found, study participants' teeth made little difference. General satisfaction with life, emotional well-being and levels of depression and anxiety were much more important to their self-esteem, according to the researchers.

Braces can improve a person's smile, and that may make a difference in teenagers' feelings of self-worth in the short-term, the study authors note.

However, they conclude, "by adulthood other psychological and social factors are of greater significance for the maintenance of general health and psychological well-being."

Article Source: Medical Health Care Information