A history and physical examination and targeted screening tests should be done to evaluate for underlying medical disorders, and children and adolescents with hypertension should be screened for comorbid cardiovascular diseases, including diabetes mellitus and hyperlipidemia. Primary hypertension is now the most common cause of hypertension in children and adolescents. Ambulatory blood pressure monitoring should be performed to confirm hypertension in children and adolescents.
In adolescents 13 years and older, elevated blood pressure is defined as blood pressure of 120 to 129 mm Hg systolic and less than 80 mm Hg diastolic, and hypertension is defined as blood pressure of 130/80 mm Hg or higher. In children younger than 13 years, elevated blood pressure is defined as blood pressure in the 90th percentile or higher for age, height, and sex, and hypertension is defined as blood pressure in the 95th percentile or higher. Children should be screened for elevated blood pressure annually beginning at three years of age or at every visit if risk factors are present.
High blood pressure in children and adolescents is a growing health problem that is often overlooked.
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