HYPERTENSION IN PEDIATRIC-PATIENTS - CURRENT ISSUES

Objective: To present current information on the diagnosis, treatment, and epidemiologic features of hypertension in children. Design: The g uidelines published by the Task Force on Blood Pressure Control in Chi ldren in 1987 are critically evaluated, and more recent data are discu ssed. Results: Prevention of the consequences of hypertension necessit ates recognition of the condition. Although hypertension in the pediat ric age-group is an uncommon finding, it does exist. The diagnosis is based on careful technique, repetitive blood pressure measurements, an d comparison with established norms. Normal blood pressure values for children have been derived from a series of large cross-sectional stud ies. 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 pr essures 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 hypertensi on. Conclusion: Treatment of children with hypertension should be indi vidualized. Etiologic evaluation is probably best performed at referra l centers.