High Blood Pressure in Children: Screening, Causes & Treatment
Updated: 2 days ago
Medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: September 2026
High blood pressure (hypertension) in children means a reading at or above the 95th percentile for children of the same sex, age, and height — or 130/80 mm Hg or higher in teenagers, the same threshold as adults. It usually causes no symptoms, which is why routine screening from age 3 matters. Younger children are more likely to have a specific underlying cause (kidney disease, heart defects, medications), while older children — especially those who are overweight — develop primary hypertension for the same lifestyle reasons as adults. Treatment starts with heart-healthy habits: weight control, a low-salt diet, and daily physical activity, with medication added when needed.
Quick Answer
Definition: blood pressure at or above the 95th percentile for the child's sex, age, and height; teens ≥ 130/80 mm Hg, same as adults
Usually no symptoms — that's why routine checks matter; screening starts at well-child visits from age 3
Two types: primary hypertension (occurs on its own, common in older children); secondary hypertension (caused by another condition, common in young children)
9 risk factors for primary hypertension — overweight, family history, type 2 diabetes, high cholesterol, excess salt, Black or Hispanic ethnicity, male sex, smoking exposure, sedentary lifestyle
Treatment starts with lifestyle: weight control, low-salt diet, 60 minutes of daily activity
Medications (ACE inhibitors, ARBs, calcium channel blockers, diuretics) for stage 2 or when lifestyle changes aren't enough
EMERGENCY: headaches, seizures, vomiting, chest pain, pounding heartbeat, or shortness of breath can signal a hypertensive crisis — seek emergency care
What Is High Blood Pressure in Children?
High blood pressure — also called hypertension — in children is blood pressure that is at or above the 95th percentile for children who are the same sex, age, and height as your child.
There isn't a simple target range for all children, because what counts as normal changes as children grow. In teenagers, however, high blood pressure is defined the same as for adults: a reading of 130/80 mm Hg or higher.
The younger a child is, the more likely the high blood pressure is caused by a specific, identifiable medical condition. Older children can develop high blood pressure for the same reasons adults do: excess weight, poor nutrition, and lack of exercise.
Lifestyle changes — such as eating a heart-healthy diet low in salt and exercising more — can help reduce high blood pressure in children. For some children, medications may also be necessary.
High Blood Pressure in Children Symptoms: What to Watch For
High blood pressure usually doesn't cause symptoms. This is exactly why routine blood pressure checks are so important — the only reliable way to detect it.
However, signs and symptoms that might indicate a high blood pressure emergency (hypertensive crisis) include:
Headaches: can signal dangerously high pressure.
Seizures: a medical emergency — call 911.
Vomiting: a possible crisis sign in a child with high BP.
Chest pains: needs immediate evaluation.
Fast, pounding or fluttering heartbeat (palpitations): heart working under strain.
Shortness of breath: can indicate a crisis — act immediately.
If your child has any of these signs or symptoms, seek emergency medical care. In an emergency, call 911.
Causes: Primary vs. Secondary Hypertension
The cause of high blood pressure in children depends largely on age.
In younger children, high blood pressure is often related to other health conditions, such as heart defects, kidney disease, genetic conditions, or hormonal disorders. This is called secondary hypertension — high blood pressure caused by another condition — and it is more common in young children.
Older children — especially those who are overweight — are more likely to have primary hypertension. This type occurs on its own, without an underlying condition, and appears more often in children age 6 and older.
Risk Factors for Primary Hypertension
Overweight or obesity: leading lifestyle risk factor.
Family history of high blood pressure: genetics play a role.
Type 2 diabetes or high fasting blood sugar: metabolic risk.
High cholesterol: metabolic risk.
Eating too much salt: dietary risk.
Being Black or Hispanic: ethnicity-related risk.
Being male: sex-related risk.
Smoking or secondhand smoke exposure: environmental risk.
Sedentary lifestyle: inactivity raises risk.
Causes of Secondary Hypertension
Secondary hypertension is caused by another condition, and the list of possible causes is broad:
Chronic kidney disease: most common cause in young children.
Polycystic kidney disease: inherited kidney condition.
Heart problems: such as severe narrowing (coarctation) of the aorta.
Adrenal disorders: hormone-related conditions.
Overactive thyroid (hyperthyroidism): thyroid hormone excess.
Narrowing of the kidney artery (renal artery stenosis): reduced blood flow to kidneys.
Sleep disorders: especially obstructive sleep apnea.
Certain drugs and medications: decongestants, ADHD stimulants, caffeine, NSAIDs, steroids.
Illicit drugs: cocaine, methamphetamine, and similar drugs.
Complications
Children who have high blood pressure are likely to continue to have high blood pressure as adults unless they begin treatment.
If high blood pressure continues into adulthood, your child could be at risk of:
Stroke
Heart attack
Heart failure
Kidney disease
Prevention
High blood pressure can be prevented in children by making the same lifestyle changes that treat it — controlling your child's weight, providing a healthy diet low in salt (sodium), and encouraging exercise.
High blood pressure caused by another condition can sometimes be controlled, or even prevented, by managing the condition that's causing it.
When to See a Doctor
Your child's blood pressure should be checked during routine well-check appointments starting at age 3 — and at every appointment if your child is found to have high blood pressure.
If your child has a condition that can increase the risk of high blood pressure — including premature birth, low birth weight, congenital heart disease, and certain kidney problems — blood pressure checks might begin soon after birth.
If you're concerned about your child having a risk factor for high blood pressure, such as obesity, talk to your child's doctor.
How Is High Blood Pressure in Children Diagnosed?
The doctor will perform a physical exam and ask about your child's medical history, family history of high blood pressure, nutrition, and activity level.
Accurate measurement matters. The correct blood pressure cuff size is essential. Blood pressure should be measured with proper technique, in a quiet environment, with the child resting comfortably. During a single visit, your child's blood pressure might be measured two or more times for accuracy.
For a diagnosis of high blood pressure, your child's blood pressure must be higher than normal when measured during at least three visits to the doctor.
Tests to Find the Underlying Cause
If your child is diagnosed with high blood pressure, the doctor will work to determine whether it's primary or secondary. These tests might be used:
Blood tests: kidney function, electrolytes, cholesterol and triglyceride levels (lipids).
Urine sample test (urinalysis): kidney and metabolic markers.
Echocardiogram: pictures of the heart and blood flow through the heart.
Kidney ultrasound (renal ultrasound): kidney structure and health.
Ambulatory Monitoring
To confirm a diagnosis, your child's doctor might recommend ambulatory monitoring — your child temporarily wears a device that measures blood pressure throughout the day, including during sleep and various activities.
Ambulatory monitoring can help rule out blood pressure that's temporarily raised because your child is nervous at the doctor's office — known as white-coat hypertension.
High Blood Pressure in Children Treatment Options
Treatment depends on severity, described in two stages:
Stage 1 hypertension: slightly or moderately high blood pressure. Lifestyle changes first (heart-healthy diet, more exercise) before medications; medication if lifestyle changes don't help.
Stage 2 hypertension: severely high blood pressure. Blood pressure medications likely recommended.
Medications
If medication is needed, options include:
ACE inhibitors: relax blood vessels by blocking a natural chemical that narrows them, making blood flow easier.
Angiotensin II receptor blockers (ARBs): relax blood vessels by blocking a natural chemical that narrows them.
Calcium channel blockers: relax the muscles of blood vessels; may also slow heart rate.
Diuretics (water pills): act on the kidneys to remove sodium and water, reducing blood pressure.
Your child's doctor will determine how long medication is needed. Importantly, if high blood pressure is caused by obesity, losing weight might make medication unnecessary. Treating other medical conditions might also control blood pressure.
Although little is known about the long-term effects of blood pressure medication on a child's growth and development, many of these medications are generally considered safe to take during childhood.
Self-Care: 6 Steps Parents Can Take
High blood pressure is treated similarly in children and adults — usually starting with lifestyle changes. Even if your child takes medication, lifestyle changes make the medication work better.
Control your child's weight: achieving a healthy weight — or maintaining weight while growing taller — can lower blood pressure.
Heart-healthy diet: emphasize fruits, vegetables, whole grains, low-fat dairy, and lean proteins (fish, beans); limit fat and sugar.
Decrease salt: children ages 2–3: no more than 1,200 mg sodium/day; older children: no more than 1,500 mg/day; limit processed foods and fast food.
Encourage physical activity: all children should get 60 minutes of moderate to vigorous activity daily.
Limit screen time: reduce time in front of TV, computers, and other devices to encourage activity.
Get the family involved: children struggle to change habits if the family doesn't eat well or exercise — set a good example and play together.
Preparing for Your Appointment
Your child's blood pressure will be checked as part of a routine physical exam or during any pediatric visit when indicated. Before a blood pressure check, make sure your child hasn't had caffeine or another stimulant.
What you can do — make a list of:
Symptoms your child has, and when they began (high blood pressure rarely causes symptoms, but it is a risk factor for heart disease)
Key personal information, including family history of high blood pressure, high cholesterol, heart disease, stroke, or diabetes
All medications, vitamins, or supplements your child takes, with doses
Your child's diet and exercise habits, including salt intake
Questions to ask
Questions worth asking:
What tests will my child need?
Will my child need medications?
What foods should my child eat or avoid?
What's an appropriate level of physical activity?
How often should I schedule blood pressure check appointments?
Should I monitor my child's blood pressure at home?
Should my child see a specialist?
Can you recommend brochures or websites?
What your child's doctor may ask:
When was your child's blood pressure last checked, and what was the reading?
Was your child premature or underweight at birth?
Does your child or anyone in the family smoke?
Bottom Line
High blood pressure in children rarely shows symptoms — but it is detectable, preventable, and treatable. Routine screening from age 3 catches it early. Lifestyle changes — healthy weight, low-salt eating, and daily activity — are the first line of treatment and often the most powerful one. When medications are needed, several safe options exist, and treating any underlying condition can sometimes resolve the problem entirely.
Your next step: Make sure your child's blood pressure is checked at every routine well visit. If your child has headaches, seizures, vomiting, chest pain, a pounding heartbeat, or shortness of breath, seek emergency medical care immediately. Talk to your pediatrician today about your child's blood pressure and heart health.
Explore more of our heart health guides: Heart Attack warning signs and emergency response and Heart Failure symptoms, causes and management.
Frequently Asked Questions
What is considered high blood pressure in children?
High blood pressure in children is defined as blood pressure at or above the 95th percentile for children of the same sex, age, and height. There is no single target number for all children because normal ranges change as children grow. In teenagers, the definition matches adults: 130/80 mm Hg or higher.
Can children have high blood pressure?
Yes. Children can have high blood pressure for several reasons. Younger children are more likely to have it caused by another condition (kidney disease, heart defects, hormonal disorders), while older children — especially those who are overweight — often develop it for the same lifestyle reasons as adults.
Does high blood pressure cause symptoms in children?
Usually not. High blood pressure typically has no symptoms, which is why routine checks are essential. However, headaches, seizures, vomiting, chest pain, a fast pounding heartbeat, or shortness of breath can signal a high blood pressure emergency (hypertensive crisis) — seek emergency care if these appear.
When should my child's blood pressure be checked?
Blood pressure should be checked at routine well-child visits starting at age 3, and at every appointment if your child has high blood pressure. If your child was born prematurely, had low birth weight, has congenital heart disease, or has certain kidney problems, checks might begin soon after birth.
What causes high blood pressure in children?
Younger children often have secondary hypertension — caused by another condition such as chronic kidney disease, heart defects, or certain medications. Older children more often have primary hypertension, driven by being overweight, family history, too much salt, type 2 diabetes, high cholesterol, smoking exposure, and a sedentary lifestyle.
How is high blood pressure in children treated?
For mildly or moderately high blood pressure (stage 1), doctors usually recommend lifestyle changes first — a heart-healthy, low-salt diet and more exercise. If those don't help, or if blood pressure is severely high (stage 2), medications such as ACE inhibitors, ARBs, calcium channel blockers, or diuretics may be prescribed.
Can a child outgrow high blood pressure?
If high blood pressure is caused by obesity, losing weight might make medication unnecessary, and treating an underlying condition may control it. But children with high blood pressure often continue to have it as adults unless treatment begins — which is why early intervention matters.
How much salt should children eat?
Children ages 2 to 3 should have no more than 1,200 milligrams of sodium a day, and older children no more than 1,500 mg a day. Processed foods and fast-food meals are often the biggest sources of sodium in a child's diet.
References
This article is for informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. This article reflects medical guidance current as of July 30, 2021.
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