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Approach to hypertensive emergencies and urgencies in children

Neil G Uspal, MD
Susan M Halbach, MD, MPH
Section Editors
George A Woodward, MD
F Bruder Stapleton, MD
Deputy Editor
James F Wiley, II, MD, MPH


This topic addresses the diagnostic approach to hypertensive emergencies in children. The treatment of pediatric hypertensive emergencies is discussed separately. (See "Management of hypertensive emergencies and urgencies in children".)


Hypertension, defined as either systolic and/or diastolic BP ≥95th percentile measured upon three or more occasions, is present in 2 to 5 percent of the pediatric population and is frequently undiagnosed [1-5]. However, hypertensive emergencies in children occur in fewer than 1 percent of emergency department (ED) visits. (See "Epidemiology, risk factors, and etiology of hypertension in children and adolescents", section on 'Epidemiology'.)


Proper management of children with elevated BP requires working knowledge of pediatric BP standards and a clear understanding of when elevated BP requires emergent, urgent, or routine care.

Hypertension in children — Hypertension is defined as either systolic and/or diastolic BP ≥95th percentile measured upon three or more occasions. The degree of hypertension is further delineated by the two following stages:

Stage 1 hypertension – Systolic and/or diastolic BP between the 95th percentile and 5 mmHg above the 99th percentile.


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Literature review current through: Jul 2017. | This topic last updated: Aug 11, 2016.
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