BACKGROUND Children have lower blood pressure than adults do, and norm
al values for children have been established based on age and also on
height and weight. Blood pressures in childhood correlate with blood p
ressures in adulthood, although weakly; a stronger correlation has bee
n established between obesity in childhood and adulthood. Further, obe
se people are more likely to have high blood pressure than are slender
people, both as children and adults. In hypertensive children, the hi
gher the blood pressure and the earlier hypertension appears, the more
likely is a secondary cause. KEY POINTS Physicians should measure and
record children's blood pressure, just as they do their height and we
ight. An algorithm can help physicians decide whether a child with hig
h blood pressure needs further workup and treatment. Nonpharmacologic
therapy includes dietary sodium restriction, weight reduction (if the
child is overweight), aerobic exercise, and relaxation. In some cases
pharmacologic therapy may be necessary. In general, all children shoul
d be encouraged to be physically active and to eat healthy foods.