Hypertension living in teenagers

Overview

Hypertension, also known as high blood pressure, is when the force of blood pushing against the walls of your blood vessels is too high most of the time. In teenagers, blood pressure that is too high can strain the heart and blood vessels. Often it has no symptoms, but it can affect your health in the long run if not managed well.

High blood pressure is less common in teenagers than in adults, but it is becoming more frequent, especially among teens who carry extra weight or have a family history of hypertension.

It can affect any teenager, but those who are overweight, eat a lot of salty or processed foods, do not exercise much, or have a family history of high blood pressure or kidney disease are at higher risk.

Symptoms

Common symptoms

• Most teens with high blood pressure have no symptoms at all.
• Sometimes, teenagers may get headaches, especially in the morning.
• Occasional nosebleeds or blurred vision can happen, but these are not specific to hypertension.

Symptoms in children

• In younger children, symptoms can include headaches, tiredness, and trouble concentrating in school.
• Rarely, there may be vomiting, fast heartbeat, or swelling in the legs.

Causes

Main causes

• Secondary hypertension: This is high blood pressure caused by another health problem, such as kidney disease, heart problems (like a narrowing of the aorta), or hormone issues (like thyroid or adrenal gland disorders).
• Primary (essential) hypertension: This is when no specific cause is found. It is more common in older teenagers and is often linked to genetics, weight, diet, and lifestyle.

Risk factors

• Being overweight or obese.
• Eating a lot of salty foods (fast food, chips, canned soups).
• Not getting enough physical activity.
• Having a close family member (parent, sibling) with high blood pressure.
• Smoking or vaping, and drinking alcohol.
• Certain medicines, like some prescription drugs for ADHD or depression.
• Stress at school or home.

When to see a doctor

See a doctor urgently if:

• If you have any of the emergency symptoms listed above, get help right away.

Book a routine appointment if:

• During your regular check-up with a doctor or school nurse, have your blood pressure measured every year.
• If you are at higher risk (overweight, family history), ask your doctor to check your blood pressure more often.

Diagnosis

A doctor or nurse will measure your blood pressure using a cuff around your arm. Because blood pressure can change throughout the day, they will take several readings on different days to confirm if it is consistently too high.

Tests that may be done

• Blood pressure checks with the correct cuff size (too small or too large can give wrong numbers).
• A 24-hour ambulatory blood pressure monitor (a device that records your blood pressure as you go about your normal day and night).
• Urine tests to check for kidney problems.
• Blood tests to check hormones and kidney function.
• An echocardiogram (ultrasound of the heart) or ultrasound of the kidneys in some cases.
• Sometimes a sleep study if sleep apnea is suspected.

What to expect at your appointment

First, the doctor will ask about your health history and do a physical exam. If your blood pressure is high, they will probably ask you to come back for more checks. You might be asked to wear a blood pressure monitor for 24 hours to get a full picture. The tests are all safe and don't hurt. Your doctor will explain each step as you go.

Treatment

Treatment for high blood pressure in teenagers depends on the cause and how high the blood pressure is. For mild cases, lifestyle changes are often the first step. If an underlying condition is found (like kidney disease), that condition needs to be treated. If lifestyle changes aren't enough, medication may be prescribed.

Self-care at home

• Eat a heart-healthy diet: more fruits, vegetables, whole grains, and lean proteins; less salt, sugar, and processed foods.
• Get at least 60 minutes of moderate to vigorous physical activity every day (like basketball, swimming, brisk walking).
• Keep a healthy weight through eating well and staying active.
• Limit screen time and get enough sleep (8–10 hours per night for teens).
• Don't smoke or vape, and avoid alcohol.
• Find healthy ways to manage stress — talk to a friend, listen to music, practice deep breathing.

Medical treatments

If lifestyle changes alone do not bring blood pressure down enough, a doctor may prescribe medication. These are usually taken once a day and are safe when used as directed. The doctor will choose the type that is best for your age and overall health. You will need regular check-ups to monitor your blood pressure and adjust the medication if needed. Never stop or change your medication without talking to your doctor.

When is surgery considered?

If high blood pressure is caused by a physical problem such as a narrowed artery or a hormone-producing tumor, surgery may be needed to fix that problem. This is not common in teenagers, but when it happens, the surgery usually takes care of the high blood pressure.

Living with this condition

Living with high blood pressure as a teenager means paying a little extra attention to your daily habits. You may need to check your blood pressure at home with a home monitor (your doctor or nurse can show you how). You'll also need to take any prescribed medications as directed. Most teenagers with high blood pressure can still do all the things they enjoy — sports, school, hanging out with friends — as long as they take care of their health.

Lifestyle tips

• Use a salt shaker sparingly; try herbs and spices to flavor food instead.
• Read food labels — aim for less than 5 grams of salt (about 1 teaspoon) per day.
• Pack your own lunches to control what you eat.
• Limit sugary drinks like soda and energy drinks.
• Walk or bike to school if possible, or join a sports team.
• Set a regular sleep schedule and avoid screens an hour before bed.

Diet and exercise

A healthy diet for teens with high blood pressure includes lots of fruits and vegetables (aim for 5 portions a day), whole grains (like oats and brown rice), and low-fat dairy. Choose lean meats and fish, and try to cut back on processed snacks, fast food, and salty cheeses. For exercise, any activity that gets your heart pumping is good — find something you enjoy, whether it's dancing, running, cycling, or team sports. Aim for at least 60 minutes on most days.

Mental health and emotional wellbeing

Being diagnosed with a health condition can feel overwhelming or stressful. You might worry about missing out on fun activities or about taking medication. It's important to talk about these feelings with someone you trust — a parent, school counsellor, or your doctor. If you ever feel very down or think about hurting yourself, please reach out to a crisis support service right away (for example, call your local emergency number or a helpline like the Samaritans in the UK). You are not alone, and help is available.

Prevention

You cannot always prevent high blood pressure, especially if it runs in your family or is caused by another condition. But healthy habits from an early age — like eating well, staying active, and avoiding smoking — can reduce your risk. If you already have high blood pressure, these same habits can help manage it and prevent it from getting worse.

Vaccines

There is no vaccine for high blood pressure. However, staying up to date on other vaccines (like the flu shot) is a good idea because being sick can sometimes affect your blood pressure.

Screening programmes

The best screening is having your blood pressure checked during regular doctor visits. Many schools also do health screenings. If you have risk factors, ask your doctor to check your blood pressure at least once a year.

Complications

If left untreated

• Damage to blood vessels and the heart, which can lead to heart disease or heart failure later in life.
• Kidney damage or kidney failure over time.
• Stroke (a blood clot or bleed in the brain).
• Vision problems due to damage to the blood vessels in the eyes.
• Aneurysm (a bulge in a blood vessel that can burst).

Long-term outlook

The good news is that high blood pressure in teenagers can often be managed very well. With the right lifestyle changes, and medication if needed, most teens go on to lead healthy, active lives without lasting problems. If the cause is found and treated (for example, a kidney problem), the blood pressure can even return to normal. Staying on top of your health now sets you up for a strong heart in adulthood.

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