Considerable advances have been made in detection, evaluation, and management of high blood pressure (BP), or hypertension, in children and adolescents. Because of the development of a large national database on normative BP levels throughout childhood, the ability to identify children who have abnormally elevated BP has improved. On the basis of developing evidence, it is now apparent that primary hypertension is detectable in the young and occurs commonly. The long-term health risks for hypertensive children and adolescents can be substantial; therefore, it is important that clinical measures be taken to reduce these risks and optimize health outcomes.
The purpose of this report is to update clinicians on the latest scientific evidence regarding BP in children and to provide recommendations for diagnosis, evaluation, and treatment of hypertension based on available evidence and consensus expert opinion of the working group when evidence was lacking. This publication is the fourth report from the National High Blood Pressure Education Program (NHBPEP) Working Group on Children and Adolescents and updates the previous 1996 publication, “Update on the 1987 Task Force Report on High Blood Pressure in Children and Adolescents.”1
This report includes the following information:
New data from the 1999–2000 National Health and Nutrition Examination Survey (NHANES) have been added to the childhood BP database, and the BP data have been reexamined. The revised BP tables now include the 50th, 90th, 95th, and 99th percentiles by gender, age, and height.
Hypertension in children and adolescents continues to be defined as systolic BP (SBP) and/or diastolic BP (DBP), that is, on repeated measurement, ≥95th percentile. BP between the 90th and 95th percentile in childhood had been designated “high normal.” To be consistent with the Seventh Report of the Joint National Committee on the Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7), …
Reprint requests to Edward J. Roccella, National High Blood Pressure Education Program, National Heart, Lung, and Blood Institute, National Institutes of Health, Bldg 31, Room 4A10, Center Dr, MSC 2480, Bethesda, MD 20892. E-mail: