Management of high blood pressure in children and adolescents.

Hypertension in childhood is now recognized to be a common and serious problem with a prevalence of 2% to 5%. Large epidemiologic studies have established normative tables for blood pressure beginning in early childhood based on age, gender, and height. Making a diagnosis of hypertension in a child or adolescent identifies an individual at increased risk for early-onset cardiovascular disease who requires specific treatment. Routine blood pressure measurement is recommended at every health care encounter beginning at 3 years of age, but often this is not being accomplished. This measurement is especially important in relation to the obesity epidemic, because approximately one-third of obese children have high blood pressure. Hypertension can be effectively managed with effective lifestyle change and medication when necessary.