HYPERTENSION IN CHILDREN AND ADOLESCENTS

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.