At just 10 years, Chandigarh-based Nishant Puri would start gasping after just five minutes in the park. His mother also noticed that he would wake up gasping for air and sweating profusely. Nishant weighed 52 kilos - definitely a lot for his 4 feet 2 inches height - and his heart rate was also much higher than normal.
As we gear up to mark World Hypertension Day on 17 May, it’s important to note that scientists are increasingly getting alarmed at the growing rate of hypertension in children in India.
Hype Over Hypertension
A study conducted in Chennai by Dr Jasmine Sundar, epidemiology department, Dr MGR Medical University showed that 21 percent of children between 13 and 17 suffered from hypertension.
Dr Anurag Sharma, a Chandigarh-based cardiologist says:On the basis of emerging evidence, it is now apparent that primary hypertension is detectable in the young and that it occurs commonly. The long-term health risks for hypertensive children and adolescents can be substantial. High blood pressure (hypertension) in children is blood pressure that’s the same as or higher than 95 percent of children who are the same sex, age and height as your child. There isn’t a simple target blood pressure reading that indicates high blood pressure in all ages for children, because what’s considered normal blood pressure changes as children grow.
He further adds:Having high blood pressure in childhood puts the kids at a higher risk of stroke, heart attack, kidney failure, loss of vision, and atherosclerosis or hardening of the arteries.
While high blood pressure doesn't always cause symptoms, it still affects the body and puts a person at risk for long-term health problems. In rare cases, severe hypertension can cause headaches, visual changes, dizziness, nosebleeds, heart palpitations, and nausea.
Often, kids and teens with hypertension won’t show any symptoms at all. But one or more of the following symptoms are common - headaches, loss of vision, double-vision, chest pain, abdominal pain, breathing problems.
The causes of high blood pressure in kids can differ, depending on a child's age. The younger the child, the more likely the high blood pressure is linked to an illness. Risk factors for high blood pressure in children include obesity and a family history of high blood pressure. Other risk factors may include medical problems such as sleep apnoea or other sleep disorders.While hypertension is far more common in adults, experts link childhood obesity to rising rates of childhood hypertension. If experts are to be believed, parents can be the root cause in more ways than one.
"While there could be genetic or medical reasons for high blood pressure in children, some of the main causes can be due to the lifestyle offered to the child, " says Dr Jasmine Sundar.
If Neena Das, a south-Delhi based mother is to be believed, this could be easier said than done.“I know the ill-effects of junk food. But my kids are teenagers and the moment they see a karela or a ghiya on the table, they both run and order pizza! What do I do?” Her exasperation is echoed by Nishant Puri’s mother, Neetu, who says, “If I ever asked him what would he like to take for tiffin, or eat, he would say ‘burger’ or ‘poori’ or ‘aloo parantha’ or ‘fried chicken’. After his fainting episodes became more frequent and we took him to the doctor, our worst fears were confirmed.”
The doctor diagnosed Nishant with severe obesity, and also as suffering from hypertension and high blood pressure.“I understand how difficult it is for families to be able to have full control over what their kids eat and how much physical activity they get. This is increasingly a public health problem,” says Avni Kaul.
Schools don’t always have budgets that allow for exercise programs and vegetables and fruits in school lunches.
But all our experts are unanimous in the opinion that parents can regulate children's lives.Avni KaulMany kids and teens with high blood pressure have an unhealthy lifestyle — a bad diet, excess weight, stress, and too little physical activity. So, I always recommend weight loss, exercise, reduced screen time (time spent watching TV, or using a computer or mobile devices), dietary changes, and even relaxation techniques. Most of these can be implemented if the parents are focused.
Focus On Prevention
“High blood pressure can be prevented in children by making the same lifestyle changes that can help treat it — controlling your child's weight, providing a healthy diet and encouraging your child to exercise. Obesity is the number one risk factor for high blood pressure in children," says Avni Kaul, adding:Not only does being obese put your child at risk of high blood pressure, but also of a range of other health problems such as heart disease and diabetes. In most cases, obesity is due to the combination of two factors: too much food (unhealthy snacks and sugary drinks) and too little physical activity.
Many children do not exercise enough and spend hours everyday engaged in sedentary activities such as watching television or playing video games.
Talking about turning her family's life, health and meal plans 360 degrees, Neetu Puri says:I knew no amount of lecturing would help. I decided to take control of what I could - what was put on the table. So, I stopped serving breakfast till everyone in the house had had their glass of warm water with lemon. I stopped cooking for at least two evenings in a week - and all of us - husband and I included started having raw fruits and vegetables for dinner - yes a soup and toast were allowed some days. After just two months, Nishant had lost six kilos. And this encouraged him to lose more - and he started playing and exercising normally. Relatives called me mad and cruel, but extreme situations call for extreme measures.
However, you may need not go to that extreme to prevent hypertension in your child.
There is a scientific diet that is doing the rounds of healthy circles the world over. It is called the DASH (Dietary Approaches to Stop Hypertension ) diet and consists of eating a diet high in seasonal fruits and vegetables, nuts, low fat dairy and complex carbohydrates. This diet helps to lower blood pressure because it has less salt and sugar. Sodium needs be restricted in the diet. Foods with high potassium magnesium and fibre are part of the DASH diet. This diet regimen also helps lower water retention.
Avni Kaul says:The most basic thing to do is include more vegetables (especially leafy green vegetables), fruits, low-fat dairy products, and fiber-rich foods, and fewer carbohydrates, fats, processed foods, and sugary drinks. Prepare low-sodium dishes or avoiding salt - especially on top of salads. As per the American Heart Association one should target less than 2300 milligrams of salt per day - that is 1 teaspoon of salt. Depending on the doctor’s and nutritionist’s advice it can go lower to 1500 milligrams also. This varies from case to case. Watch out for foods with lots of hidden salt like bread, sandwiches, pizza, and many restaurant and fast-food options.