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Nonemergent 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.

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".)


In children, definitions based upon the 2017 American Academy of Pediatrics (AAP) guidelines for screening and managing high blood pressure for children and adolescents for high blood pressure (BP) in children and adolescents are used to classify BP measurements for two different age groups in the United States (table 1) [1]. BP percentiles are based upon gender, age, and height (table 2 and table 3). (See "Definition and diagnosis of hypertension in children and adolescents", section on 'Definition'.)

Childhood HTN is also divided into two categories depending upon whether or not an underlying cause can be identified (table 4):

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Literature review current through: Oct 2017. | This topic last updated: Oct 13, 2017.
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