Fat Boys, Beware

By Christine Gorman

For years pediatricians didn't worry much about treating hypertension in their patients. After all, kids grow so fast, it's hard keeping up with their shoe size, let alone their blood pressure. Sure, hypertension in adults places them at greater risk of heart attack and stroke. But nobody likes the idea of starting youngsters on blood-pressure medicine they could wind up taking the rest of their lives. Who knows what previously unheard-of side effects could crop up after five or six decades of daily use? The rationale has been: kids grow out of so many things, maybe they'll grow out of this too.

Now, though, comes word that high blood pressure can be destructive even in childhood. According to a report last week in the journal Circulation, 19 of 130 children with high blood pressure developed a dangerous thickening of the heart muscle that, in adults at least, has been linked to heart failure. "No one knows if this pattern holds true for younger patients as well," says Dr. Stephen Daniels, a pediatric cardiologist who led the study at Children's Hospital Medical Center in Cincinnati, Ohio. "But it's worrisome."

Who's most at risk? Boys more than girls, especially boys who are overweight. Their heart works so hard to force blood through extra layers of fat that its walls grow more dense. Then, after decades of straining, it grows too big to pump blood very well. Fortunately, the abnormal thickening can be spotted by ultrasound. And in most cases, getting that blood pressure under control--through weight loss and exercise or, as a last resort, drug treatment--allows the overworked muscle to shrink to normal size.

How can you tell if yours are among the 670,000 American children ages 10 to 18 with high blood pressure? It's not the sort of thing you can catch by putting your child's arm in a cuff at the free monitoring station in your local grocery. You should have a test done by a doctor, who will consult special tables that indicate the normal range of blood pressure for a particular child's age, height and sex. If the doctor finds an abnormal result, she will repeat the test over a period of months to make sure the reading isn't a fluke. She'll also check whether other conditions, like kidney disease, could be the source of the trouble. Because hypertension can be hard to detect, the National Heart, Lung and Blood Institute recommends annual blood-pressure checks for every child over age 3.

About half the cases of hypertension stem directly from kids being overweight. And the problem is likely to grow. Over the past 30 years, the proportion of U.S. children who are overweight has doubled, from 5% to 11%, or 4.7 million kids.

You can keep your children from joining their ranks by clearing the junk food from your pantry and hooking your kids--the earlier the better--on healthy, attractive snacks like fruits (try freezing some grapes) or carrot sticks with salsa. Not only will they lower your children's blood pressure; these foods will also boost their immune system and unclog their plumbing. Meanwhile, make sure your kids spend more time on the playground than with their PlayStation. Even if they don't shed a pound, vigorous exercise will help keep their blood vessels nice and wide, lowering their blood pressure. And of course, they'll be more likely to eat right and exercise if you set a good example.

For more information from Christine Gorman about high blood pressure in children, visit time.com