Consultation with the specialist. The diagnosis of hypertension in children: an update.

Elevated blood pressure is associated with an increased risk of cardiovascular disease morbidity and mortality. Indirect evidence indicates that this process may begin early in life. Now that substantial data define the distribution of blood pressure in healthy children and adolescents, it is the role of the pediatrician to identify those children at the upper end of the distribution. Identification of children who have elevated blood pressure allows the physician to pursue the appropriate clinical evaluation and institute nonpharmacologic or pharmacologic treatment as needed.