CARDIOVASCULAR

SYSTEM

>HYPERTENSION IN
CHILDREN
▪ Blood pressure (BP) is the pressure of circulating
blood against the walls of blood vessels. Most of
this pressure results from the heart pumping blood
through the circulatory system. When used without
qualification, the term "blood pressure" refers to
the pressure in the large arteries.

▪ It usually expressed in terms of the systolic

pressure over diastolic pressure (minimum
pressure between two heartbeats) in the cardiac
cycle. It is measured in millimeters of mercury
(mmHg) above the surrounding atmospheric
pressure.
NORMAL CARDIOVASCULAR SYSTEM ON
CHILDREN
NORMAL RANGE OF BLOOD PRESSURE IN CHILDREN BY
AGE

Systolic BP (in Diastolic BP (in

Age
mmHg) mmHg)

Infant 72-104 37-56

Toddler (1-2 years old) 85-113 37-69

Preschooler (3-5 years

91-120 46-80
old)

Child (6-12 years old) 96-131 55-62

Adolescent (13-17
108-143 62-94
years old)
 HYPERTENSION IN CHILDREN

▪ High blood pressure (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.

▪ Means the pressure inside the arteries is too high. This higher
pressure may harm the arteries and cause the heart to work hard.

▪ Hypertension can damage the arteries by making them less

elastic, which decreases the flow of blood and oxygen to the heart
and leads to heart disease.
Symptoms of Hypertension to Children:

 High blood pressure usually doesn't cause

symptoms. However, signs and symptoms that might

indicate a high blood pressure emergency

(hypertensive crisis) include:

▪ Headaches

▪ Seizures

▪ Vomiting

▪ Chest pains

▪ Fast, pounding or fluttering heartbeat (palpitations)

▪ Shortness of breath
Causes of Hypertension to Children:

 High blood pressure in younger children is often related to other health conditions, such as heart
defects, kidney disease, genetic conditions or hormonal disorders. Older children — especially
those who are overweight — are more likely to have primary hypertension. This type of high blood
pressure occurs on its own, without an underlying condition.
 Primary hypertension  Secondary hypertension
The risk factors for developing primary Other causes of high blood pressure include:
hypertension include: Chronic kidney disease
• Being overweight or having obesity • Polycystic kidney disease
• Having a family history of high blood pressure • Heart problems, such as severe narrowing
• Having type 2 diabetes or a high fasting blood (coarctation) of the aorta
• Adrenal disorders
sugar level
• Having high cholesterol • Overactive thyroid (hyperthyroidism)
• Eating too much salt • Narrowing of the artery to the kidney (renal artery
• Being Black or Hispanic stenosis)
• Being male • Sleep disorders, especially obstructive sleep apnea
• Smoking or exposure to secondhand smoke • Certain drugs and medications, including those
• Being sedentary stimulants used to treat
attention-deficit/hyperactivity disorder, and caffeine.
HOW HYPERTENSION AFFECT
THE
CARDIOVASCULAR SYSTEM?

 High blood pressure can damage your

arteries by making them less elastic,
which decreases the flow of blood and
oxygen to your heart and leads to heart
disease.
HOW VASOCONSTRICTION HAPPEN IN THE CARDIOVASCULAR
SYSTEM?

▪When blood vessels become narrow (vasoconstriction), it

takes more pressure for the blood to travel through the

blood vessels.

▪High blood pressure (also called hypertension) happens

when your blood moves through your arteries at a higher

pressure than normal.

 NURSING INTERVENTIONS/RESPONSIBILITIES

Lifestyle and home remedies

High blood pressure is treated similarly in children and adults,
usually starting with lifestyle changes. Even if your child takes
medication for high blood pressure, lifestyle changes can make the
medication work better.
Control your child's weight.
If your child is overweight, achieving a healthy weight or maintaining
the same weight while getting taller can lower blood pressure.
Give your child a healthy diet.
Encourage your child to eat a heart-healthy diet, emphasizing fruits,
vegetables, whole grains, low-fat dairy products and lean sources of
protein, such as fish and beans, and limiting fat and sugar.
 NURSING INTERVENTIONS/RESPONSIBILITIES

Decrease salt in your child's diet.

Cutting the amount of salt (sodium) in your child's diet will help lower his
or her blood pressure. Children ages 2 to 3 shouldn't have more than
1,200 milligrams (mg) of sodium a day, and older children shouldn't
have more than 1,500 mg a day.

Limit processed foods, which are often high in sodium, and limit eating
at fast-food restaurants, whose menu items are full of salt, fat and
calories.

Encourage physical activity.

All children should get 60 minutes of moderate to vigorous physical
activity a day.
 NURSING INTERVENTIONS/RESPONSIBILITIES

Limit screen time.

To encourage your child to be more active, limit time in front
of the television, computer or other devices.

Get the family involved.

It can be hard for your child to make healthy lifestyle changes
if other family members don't eat well or exercise. Set a good
example. Your whole family will benefit from eating better.
Create family fun by playing together — ride bikes, play catch
or take a walk.
 NURSING INTERVENTIONS/RESPONSIBILITIES

Home monitoring of BP (if appropriate) and

correct blood pressure cuff size.
Perform a comprehensive cardiopulmonary assessment:
Heart sounds, Lung sounds, Pulses, Edema.
Promote rest, cluster care.
Assess BP and HR before and after BP lowering
meds are administered.
MEDICATIONS/DRUGS OF
HYPERTENTION IN
CHILDREN
 Furosemide
(Loop diuretics)
 Labetalol
(Beta-blocker)
 Hydralazine
(Vasodilators)
 Amlodipine
(Calcium Channel Blockers)
 Propanolol
(Beta adrenergic receptor blocker)
 Losartan
(Angiotensine)
 o Furosemide (Loop diuretics)

NAME OF DRUG ROUTE AND DOSAGE INDICATION CONTRAINDICATION SIDE EFFECTS/

ADVERSE EFFECTS

Furosemide Initial:  Edema  Anuria  Hypochlore

(Loop diuretics) - 0.5 to 2  Congestive  Hepatic coma or mic
mg/kg/DOS heart failure instates of severe in metabolic
E (20 to 80   states of severe alkalosis
mg/DOSE), electrolyte depletion hypokalemia
given once  Hypomagnes
to four emia
times daily  Hypovolemia
Maximum:  ototoxicity
- 6 (related to
mg/kg/DAY higher
(600 doses)
mg/DAY)  nephrolithia
sis with
long-term
use in
premature
infants.
o Labetalol (Beta-blocker)

ROUTE AND INDICATION CONTRAINDICATION SIDE EFFECTS/

DOSAGE ADVERSE
EFFECTS
Initial:  Hypertension  Cardiogenic shock  Edema
- 1 to 3  Hypertensive  Sinus bradycardia and  orthostatic
mg/kg/DAY crisis greater than first degree hypotension
(200 mg/DAY) block  headache
divided twice  Bronchial asthma
daily  
Maximum:
- 10 to 12
mg/kg/DAY
(1200
mg/DAY)
 o Hydralazine (Vasodilators)

ROUTE AND DOSAGE INDICATION CONTRAINDICATION SIDE EFFECTS/ ADVERSE EFFECTS

3 months-2 months
- to 0.5mg per
 chronic  hypersensitivity to  Orthostatic
kg/dose IV for 3- hypertension hydralazine hypotension
4x/day
>12 months  hypertensive  coronary artery  reflex tachycardia
- 5mg/kg IV/IM crisis disease; mitral  dizziness
every 4-6 divided
doses  severe vasvular rheumatic  peripheral edema
Maximum:
- 20mg/dose or
essential heart disease  lupus-like syndrome
200mg/day hypertension
 
Chronic HPN
Initial:
- 0.75mg-1/mg/
kg/day orally 2-
4x/day
For < 12 mos
- 5mg/kg/day
orally 2-4x/day
For > 12 mos
- 7.5 mg/kg/day
orally divided
into 4 daily
doses. Max. is
200 mg/day
 
 
 o Amlodipine (Calcium Channel Blockers)

ROUTE AND INDICATION CONTRAINDICATION SIDE EFFECTS/

DOSAGE ADVERSE EFFECTS

1 to 5 years old:  hypertension  dihydropyridine  Constipation

Initial:   hypersensitivity  Dizziness
- 0.05 to 0.1   Flushing

mg/kg/DAY
   Palpitations
Maximum:
- 0.6    tachycardia
mg/kg/DAY (5    peripheral
mg/DAY)   edema
   
6 to 17 years  
old:  
Initial:
 
- 2.5 to 5 mg
once daily  
Maximum:  
- 10 mg/DAY
 
o Propanolol (Beta adrenergic receptor blocker)

ROUTE AND DOSAGE INDICATION CONTRAINDICATION SIDE EFFECTS/

ADVERSE EFFECTS
Neonates  supraventricu  cardiogenic shock  Syncope
Initial:
- 0.25 to 0.5 lar  sinus bradycardia  Bradycardia
mg/kg/DOSE, arrhythmias  bronchial asthma  AV block,
given two to  ventricular  congestive heart failure cold
three times
daily tachycardia   extremities
Maximum:  hypertension  Depression
- 4 mg/kg/DAY  hyperthyroidi  Vertigo
 
Children/ sm  Nightmares
Adolescents  infantile  musculoskele
Initial: hemangioma tal pain
- 1 to 2
mg/kg/DAY    tinnitus
divided two to
three time daily
Maximum:
- 4 mg/kg/DAY
(640 mg/DAY)
 o Losartan (Angiotensine)

ROUTE AND DOSAGE INDICATION CONTRAINDICATION SIDE EFFECTS/

ADVERSE EFFECTS

≥ 6 to < 17 years  Hypertension  Hypersensitivity  orthostatic

old:
Initial:
  Caution: hypotension
- 0.7 mg/kg/DAY Renal artery stenosis,  headache
(50 mg/DAY) renal impairment or 
given once daily
Maximum: hepatic impairment, hyperkalemia
- 1.4 mg/kg/DAY volume depletion,  Angioedema
(100/DAY) hyponatremia, severe  dry cough
 
≥ 17 years old: congestive heart failure (incidence
Initial: higher in
25-50 mg once those with
daily
Maximum: cough on
150 mg/DAY ACE-I)
References;

https://en.wikipedia.org/wiki/Blood_pressure#:~:text=Blood%20pressur
e%20(BP)%20is%20the,pressure%20in%20the%20large%20arteries.
https://my.clevelandclinic.org/health/symptoms/21697-vasoconstriction
https://www.mayoclinic.org/diseases-conditions/high-blood-pressure-in-c
hildren/symptoms-causes/syc-20373440
https://
www.mayoclinic.org/diseases-conditions/high-blood-pressure-in-children/
diagnosis-treatment/drc-20373446
GROUP 9C

NGAYAWON RHENZY S.
PABLO,JACKSON G.
PACLIW,NHIZA B.
PIWI,CASSANDRA JADE
POLIGON,DEMREI L.