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Consultation with the Specialist: The Diagnosis of Hypertension in Children: An Update

	Introduction

It is clear that elevated blood pressure in childhood is an important clinical problem because of the tendency for blood pressure levels to track over time. This means that children and adolescents whose blood pressures are in the upper percentiles are more likely to become young adults who have elevated blood pressure. When factors other than blood pressure, such as diet, exercise, and the level of obesity, are taken into account, this relationship becomes even stronger. In addition, it has been shown that the level of blood pressure in childhood is related to the development of aortic and coronary artery atherosclerotic lesions observed at autopsy in victims of accidental death, and childhood blood pressure levels now have been linked to the presence of coronary artery calcifications in young adults. Such coronary artery calcifications have been shown to be associated closely with clinically significant abnormalities of the coronary arteries, leading to morbidity and mortality in older adults.

The focus of this article is to provide an update for pediatricians on the measurement of blood pressure, interpretation of these measurements, and the clinical evaluation of children found to have elevated levels. Much of this information is not new, but several studies have documented that improvement is needed in the clinical application of this knowledge.

	Measurement of Blood Pressure

 
It is important to have accurate . . . [Full Text of this Article]

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