Background: Children have lower blood pressure than adults do, and normal values for children have been established based on age and also on height and weight. Blood pressures in childhood correlate with blood pressures in adulthood, although weakly; a stronger correlation has been established between obesity in childhood and adulthood. Further, obese people are more likely to have high blood pressure than are slender people, both as children and adults. In hypertensive children, the higher 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 weight. An algorithm can help physicians decide whether a child with high 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 should be encouraged to be physically active and to eat healthy foods.