Hypertension in pediatric patients: current issues.
OBJECTIVE
To present current information on the diagnosis, treatment, and epidemiologic features of hypertension in children.


METHODS
The guidelines published by the Task Force on Blood Pressure Control in Children in 1987 are critically evaluated, and more recent data are discussed.


RESULTS
Prevention of the consequences of hypertension necessitates recognition of the condition. Although hypertension in the pediatric age-group is an uncommon finding, it does exist. The diagnosis is based on careful technique, repetitive blood pressure measurements, and comparison with established norms. Normal blood pressure values for children have been derived from a series of large cross-sectional studies. Although they have certain shortcomings, they are useful. Height and weight are important determinants in the use of the normative data. The selection of a blood pressure cuff that completely encircles the arm is crucial. Tracking--the persistence of systolic and diastolic pressures at stable percentiles--is not a constant finding, but children at risk for development of hypertension as adults may be identifiable. As in the adult population, children with hypertension have no signs or symptoms that clearly distinguish primary from secondary hypertension.


CONCLUSIONS
Treatment of children with hypertension should be individualized. Etiologic evaluation is probably best performed at referral centers.
Morgenstern
B Z
BZ
Section of Pediatric Nephrology, Mayo Clinic Rochester, MN 55905.
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D007223:Infant; D007231:Infant, Newborn; D014481:United States / Q000453:epidemiology