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Ambulatory (outpatient) treatment of hypertension in children and adolescents

Tej K Mattoo, MD, DCH, FRCP
Section Editor
F Bruder Stapleton, MD
Deputy Editor
Melanie S Kim, MD


It has become clear that hypertension (HTN) begins in childhood and adolescence and that it contributes to the early development of cardiovascular disease (CVD). In hypertensive adults, multiple randomized trials have shown that reduction of blood pressure (BP) by antihypertensive therapy reduces cardiovascular morbidity and mortality. Based upon these observations, identifying children with HTN and successfully treating their HTN should have an important impact on long-term outcomes of CVD. (See "Hypertension: Who should be treated?".)

Issues related to the ambulatory (outpatient) treatment of persistent HTN in children and adolescents will be reviewed here. The epidemiology, etiology, diagnosis, and evaluation of HTN are discussed separately. (See "Epidemiology, risk factors, and etiology of hypertension in children and adolescents" and "Definition and diagnosis of hypertension in children and adolescents" and "Evaluation of hypertension in children and adolescents".)

The treatment of hypertensive emergencies and urgencies in children is also presented elsewhere. (See "Management of hypertensive emergencies and urgencies in children".)


For children in the United States, the following definitions based upon the 2004 National High Blood Pressure Education Program Working Group (NHBPEP) are used to classify blood pressure (BP) measurements [1]. BP percentiles are based upon gender, age, and height derived from normative data (table 1 and table 2). The systolic and diastolic BPs are of equal importance; if there is a disparity between the two, the higher value determines the BP category. The age- and height-specific BP percentiles may be determined using calculators for boys (calculator 1) or for girls (calculator 2).

Normal BP – Both systolic and diastolic BP <90th percentile.


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Literature review current through: Sep 2016. | This topic last updated: Mar 14, 2016.
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