Diagnostic evaluation of hypertensive children.

The approach to the diagnosis of established hypertension in childhood can be systematized and focused. The investigation of affected children evolves in an orderly fashion based on data collected from a thorough history and physical examination. Laboratory tests, in the majority of children, can then be selected on the basis of the highest index of suspicion. The cause is often not obscure, and the need to order tests related to several organ systems is avoidable. In a small percentage of patients, however, usually younger children, the cause of hypertension remains obscure until detailed investigations have been performed.