Links To And Excerpts From The Cribsiders’ Managing Pediatric Hypertension

Another great resource on pediatric hypertension is Clinical Practice Guideline for Screening and Management of High Blood Pressure in Children and Adolescents  [PubMed Abstract] [Full-Text HTML] [Full-Text PDF]. Pediatrics. 2017 Sep;140(3):e20171904.

In this post I link to and excerpt from The Cribsiders#36: Off the Cuff – Managing Pediatric Hypertension in Your Primary Care Clinic. OCTOBER 13, 2021 By DR SAM MASUR.

All that follows is from the above resource.

Pediatric Hypertension Pearls

  1. An appropriate cuff size is a cuff with an inflatable bladder width that is at least 40 percent of the arm circumference and a bladder length that covers 80–100 percent of the circumference of the arms.
  2. Younger children with elevated blood pressure should raise concern for primary causes of hypertension.*
  3. Lifestyle modification works best when it fits the context of the child.

*”Children and adolescents ≥6 years of age do not require an extensive evaluation for secondary causes of HTN if they have a positive family history of HTN, are overweight or obese, and/or do not have history or physical examination findings (Table 14) suggestive of a secondary cause of HTN (grade C, moderate recommendation).”

The above is from Clinical Practice Guideline for Screening and Management of High Blood Pressure in Children and Adolescents  [PubMed Abstract] [Full-Text HTML] [Full-Text PDF]. Pediatrics. 2017 Sep;140(3):e20171904.

Defining Pediatric Hypertension 

The Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents has a table for pediatric values. Children under the age 13 are classified via percentile.

  • under 90% = Normal
  • 90-95% or >120/80 (even if this is lower than 90-95%)) = Elevated
  • >95% = Hypertension

Children over the age of 13 are classified using adult guidelines.

Elevated blood pressure has some vascular changes and hypertension correlates with target organ damage and long term consequences.

This entry was posted in Cribsiders, Guidelines, Pediatric Guidelines, The Cribsiders. Bookmark the permalink.