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It's Morning Edition from NPR News. Good morning, I'm Steve Inskeep. On this Monday, Your Health, how storytelling can help people with dementia. We'll have that in a moment. First, high blood pressure in children. Every routine doctor's visit should include a blood pressure measurement from the age of 3 onward. But, as NPR's Patti Neighmond reports, doctors don't always do that and often don't recognize when a child's blood pressure is high.

PATTI NEIGHMOND, BYLINE: At the Corner Health Center in Ypsilanti, Michigan, family physician Margaret Riley takes 15-year-old Sara Horn's blood pressure.

DR. MARGARET RILEY: OK, I'm just going to hold your arm up, just rest on my arm. It should feel nice and heavy. That's perfect.

SARAH HORN: It feels like a marshmallow around my arm or something.

NEIGHMOND: Sara's a healthy weight and very active. She plays basketball and runs track. So, the news is good.

RILEY: Very fit, normal blood pressure.

NEIGHMOND: That's not the case for lots of teens who come here. Nationwide, nearly a third of teenagers are overweight or obese, putting them at risk of high blood pressure. When Riley looked at the latest data, she found that among those children who actually had high blood pressure only 26 percent of them had it written in their medical record.

RILEY: The physician often will put the blood pressure value in their notes, but they won't address it if it's high, because they won't have recognized that it's actually an abnormal value for that specific child.

NEIGHMOND: That's because diagnosing high blood pressure in children is more complicated than it is in adults.

RILEY: In adults anything over 140/90 is considered abnormal. In kids, it's different based on the size of their body. So for a 15-year-old boy - a normal blood pressure for him is different from that of an 8-year-old girl.

NEIGHMOND: Which means physicians have to compare a child's blood pressure to national charts of healthy levels for children the same age, gender and height.

RILEY: Yu have to do a lot of steps. I think clinicians are used to seeing number like 100/60 and that looks good on first glance, but if you actually looked for that specific child's age and height, then it may be high for them.

NEIGHMOND: And not diagnosing and treating high blood pressure in kids can set off a dangerous chain reaction. Dr. Reginald Washington is a pediatric cardiologist at Rocky Mountain Hospital for Children.

DR. REGINALD WASHINGTON: The problem is the body doesn't forgive this. So, if you have high blood pressure, high cholesterol or any of those risk factors as a child, you're setting yourself up for what we call premature problems. So patients can have strokes actually in their 20s and 30s if they have high blood pressure that's untreated.

NEIGHMOND: According to one estimate, about 2,000 children and teens suffer strokes every year as a result of hypertension. The good news, says Washington, medication is generally not needed for this age group. Simple lifestyle changes can do the trick.

WASHINGTON: If they have salt on their French fries, we encourage them maybe to eat half as many French fries and try to wean themselves off the salt or the ketchup. If they're a couch potato, we encourage the entire family to go for a walk, for example, once a day.

NEIGHMOND: And families are often more motivated when their child's health is at stake. And because of metabolism, it's easier for kids to lose weight than adults. So if a child is over 3, Dr. Riley says parents should make sure physicians measure blood pressure and compare it to national charts of healthy levels.

RILEY: They can also ask is the blood pressure normal? That would be good. That may cue the physician to check it against the charts as opposed to just brushing past the number.

NEIGHMOND: And parents should model healthy lifestyles too, says Riley, exercising regularly and eating as few processed foods as possible.

Patti Neighmond, NPR News.

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