Pediatric Hypertension: Review of Updated Guidelines

Introduction

After the publication of my review on pediatric hypertension, the American Academy of Pediatrics' Subcommittee on Screening and Management of High Blood Pressure in Children issued new Clinical Practice Guidelines for Screening and Management of High Blood Pressure in Children and Adolescents. (1)(2) These guidelines represent an update to the Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents that was published in 2004. (3) For the new guidelines, the subcommittee consisted of 17 members and was co-chaired by a pediatric nephrologist and a general pediatrician. To develop these recommendations, an extensive literature review addressing the diagnosis, management, and treatment of pediatric hypertension was conducted. Articles were then reviewed by 2 subcommittee members. Selected articles were then evaluated for quality of evidence based on an AAP grading matrix. From this, 30 key action statements were developed. In addition, 27 additional recommendations based on consensus expert opinion were also provided. Herein I highlight 7 significant changes in the initial screening and management of pediatric patients with hypertension that are important to primary care pediatricians.